Richard W. Bergstrom, MD; James R. Kelley, MD; W. Kenneth Ward, MD
To the editors: The letter of Holt and colleagues (1) emphasizes that diabetic subjects with hemoglobin S or C traits will have a falsely low hemoglobin A1c value if measured by certain methods. We also have observed this finding but would like to highlight another common condition which alters hemoglobin A1c values. Persons with the trait or who are homozygous for the hereditary persistence of fetal hemoglobin will have a falsely elevated hemoglobin A1c value (2) because hemoglobin F co-elutes with the hemoglobin A1c fraction. Some patients who were referred to our institution for presumed diabetes based on an elevated
Bergstrom RW, Kelley JR, Ward WK. Fetal Hemoglobin Alters Hemoglobin A1c Measurements. Ann Intern Med. ;115:656. doi: 10.7326/0003-4819-115-8-656_1
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Published: Ann Intern Med. 1991;115(8):656.
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