The First Case of Hemoglobin J-Guantanamo Reported During HbA1c Measurement by High-Performance Liquid Chromatography at Moroccan Military Hospital Mohammed V.

ABSTRACT

We present a 57-year-old woman with diabetes mellitus and no other known comorbidities. HbA1c measurement by high-performance liquid chromatography (HPLC) gave unquantified results and a supernumerary peak was detected on the chromatogram. A thorough exploration of the hemoglobin profile showed the presence of an unclassified variant. Alkaline pH capillary electrophoresis revealed the presence of an abnormal peak migrating at zone 11, comprising 40.1% of total hemoglobin. An abnormal band migrating between hemoglobin A and hemoglobin F was observed by acid gel electrophoresis. Sequencing of the ß-globin gene confirmed the presence of a rare hemoglobin variant, hemoglobin J-Guantanamo (HBBc.386C>A) in the heterozygous state, which was for the first time documented in Morocco. Through this report, we emphasize the importance of careful analysis of the HPLC chromatogram for the detection of possible hemoglobin variants in HbA1c measurement.