Hemoglobin electrophoresis and hereditary blood diseases

Has your doctor recommended a Hemoglobin Electrophoresis test (Hb Electrophoresis)?This test is used to detect abnormal types of hemoglobin—such as Hb S, Hb C, and Hb F—and plays a crucial role in diagnosing inherited blood disorders like thalassemia and sickle cell anemia.In this article from Dalili Medical, we guide you through a simplified overview of the test’s importance, when it’s recommended, how it's done, and how to interpret the results.

What Is Hemoglobin?

Hemoglobin is a protein found in red blood cells responsible for transporting oxygen from the lungs to all parts of the body.
It is made up of four protein chains (α, β, γ, and δ), and the types of hemoglobin vary depending on these chains:

• Hb A: The most common normal hemoglobin in adults

• Hb A2: A normal type found in small amounts

• Hb F: Fetal hemoglobin, present in low levels after birth

• Hb S, Hb C: Abnormal types linked to inherited blood disorders

What Is Hemoglobin Electrophoresis?

Hemoglobin Electrophoresis is a laboratory test used to identify the different types of hemoglobin present in the blood and determine their percentages.
The test separates hemoglobin types using an electric field based on their charge and weight.

When Is Hb Electrophoresis Ordered?

Doctors may recommend this test in the following situations:

✅ Suspected conditions like:

• Sickle cell anemia

• Thalassemia

• Unexplained anemia

• Chronic symptoms like fatigue or pale skin

• Family history of inherited blood disorders

✅ Also used during:

• Pre-marital screening

• Pregnancy evaluations if a genetic disorder is suspected

• Pediatric assessments for growth delay or chronic anemia

Types of Hemoglobin Detected by the Test

How to Interpret Hb Electrophoresis Results

1. Presence of Hb S:

   • High level = Sickle Cell Anemia

   • Moderate level with Hb A = Sickle Cell Trait

2. High Hb A2 (>3.5%)
   ➤ May indicate β-Thalassemia Minor

3. High Hb F:
   ➤ May suggest:

   • β-Thalassemia Major

   • Aplastic anemia

   • Some rare inherited syndromes (e.g., Fanconi anemia, Cushing’s syndrome)

How Is the Test Performed?

• A blood sample is drawn from a vein.

• The sample is analyzed in a lab using electrophoresis to separate hemoglobin types.

• Results are usually available within 1–3 days.

Does the Test Require Fasting?

❌ No. Fasting is not required. The test can be done at any time of the day.

Hb Electrophoresis vs. Total Hemoglobin Test

When Are Abnormal Results Seen?

This test may detect abnormalities in conditions like:

• Thalassemia (α and β types)

• Sickle cell anemia

• Hemoglobin C and E disorders

• Rare types like Hb D or Hb H disease

• Liver disease or kidney failure (may show mild variations)

Frequently Asked Questions (FAQ)

❓ Can I be a carrier of a genetic disorder without symptoms?
✅ Yes. Many carriers show no signs and are only diagnosed through this test.

❓ Is the test necessary before marriage?
✅ In some countries, it’s mandatory to prevent passing genetic blood diseases to children.

❓ Do children need the test?
✅ Yes, especially in cases of unexplained anemia or developmental delay.

❓ Is the test accurate?
✅ Absolutely. It’s one of the most reliable tests for identifying hemoglobinopathies.

Conclusion

Hemoglobin Electrophoresis is a simple yet powerful diagnostic tool used to detect inherited blood disorders like thalassemia and sickle cell anemia.

If you experience persistent fatigue, pale skin, or have a family history of blood conditions, don't hesitate to take this test.
✅ Early detection provides better management, prevention, and access to genetic counseling.