3.1 Abnormal Hemoglobin Electrophoresis
The analysis of 4009 samples resulted in the creation of chromatograms by noting retention times and area percentages of additional peaks and windows for structural variations, as well as HbA2 and F concentrations for beta-thalassemia. Each chromatogram displays the peaks of the hemoglobins A0, A2, and F as well as the windows C, D, and S and the two secondary peaks P2 and P3. Numerous hemoglobin variants elute within the same frame, and they were provisorily identified by retention time and area percentage while considering the patients' racial backgrounds.
Other relevant tests were done, for example, the sickling test as supporting evidence of Hb S. Family study was carried out whenever possible and correlation with findings of Hb electrophoresis result was done in a few cases.
Fig.1 shows the total number of normal hemoglobin and abnormal cases for each year. In 2019 the total number of normal hemoglobin was 1542 subjects and the total number of abnormal hemoglobin was 67 subjects, in 2020 the total number of normal hemoglobin was 1370 subjects and the total number of abnormal hemoglobin was 30 subjects, in 2021 the total number of normal hemoglobin was 970 subjects and the total number of abnormal hemoglobin was 30 subjects.
Fig.2 shows the total number of normal hemoglobin and abnormal hemoglobin diseases during 3 years. The total number of normal hemoglobin was 3882 subjects, sickle cell trait was the most common hemoglobin disease accounting for 66 subjects (n=66). This is followed by the B-thal trait accounting for 50 subjects (n=50), followed by sickle cell disease accounting for 9 subjects (n=9), followed by hemoglobin D trait accounting for 1 subject (n=1), and hemoglobin E disease accounting for 1 subject (n=1).
3.2 The pattern of sickle cell disease and trait
Fig. 3 shows the hemoglobin pattern in sickle cell trait cases. As shown in fig. 3 the mean value of hemoglobin S in Sickle cell trait cases was 28.8±9.8 SD.
The mean value ± SD of hemoglobin type A in normal subjects was 77.7±54.2 compared to hemoglobin type A in sickle cell trait cases (63.3±19.1). The mean value ± SD of hemoglobin type A2 in normal subjects was 2.7±0.3 compared to hemoglobin type A2 in sickle cell trait cases (3.4±0.9). The mean value ± SD of hemoglobin F in normal subjects was 0.4
±0.4 compared to hemoglobin F in sickle cell trait (1.5±2.2).
Fig. 4 shows the hemoglobin pattern in sickle cell disease cases. As shown in fig. 4 the mean value of hemoglobin S in Sickle cell disease cases was 70.9±11.9. The mean value ± SD of hemoglobin type A in normal subjects was 77.7±54.2 compared to hemoglobin type A in sickle cell disease cases (7.4±15.1). The mean value ± SD of hemoglobin type A2 in normal subjects was 2.7±0.3 compared to hemoglobin type A2 in sickle cell disease cases (2.4±0.6). The mean value ± SD of hemoglobin F in normal subjects was 0.4±0.4 compared to hemoglobin F in sickle cell disease cases (18.1±10.6).
3.3 The pattern of β - thalassemia trait and hemoglobin E disease
Fig.5 shows the hemoglobin pattern in B-thal trait cases. As shown in fig.5 the mean value ± SD of hemoglobin type A in normal subjects was 77.7±54.2 compared to hemoglobin type A in B-thalassemia trait cases (91.0±4.3). The mean value ± SD of hemoglobin type A2 in normal subjects was 2.7±0.3 compared to hemoglobin type A2 in B-thalassemia trait cases (4.9±1.3). The mean value ± SD of hemoglobin F in normal subjects was 0.4
±0.4 compared to hemoglobin F in B-thalassemia trait cases (2.8±2.8).
Fig. 6 shows the hemoglobin pattern in the hemoglobin E disease case. As shown in fig. 6
the mean value ± SD of hemoglobin type A in normal subjects was 77.7±54.2 compared to hemoglobin type A in hemoglobin E disease case (71.8±0.0). The mean value ± SD of hemoglobin type A2 in normal subjects was 2.7±0.3 compared to hemoglobin type A2 in hemoglobin E disease case (27.6±0.0). The mean value ± SD of hemoglobin F in normal subjects was 0.4±0.4 compared to hemoglobin F in hemoglobin E disease case (0.6±0.0).
3.4 The pattern of Hemoglobin in D trait case
Fig. 7 shows a pattern of hemoglobin in the D disease case. As shown in fig. 7 the mean value ± SD of hemoglobin D in the D trait case was 21.1±14.1.
The mean value ± SD of hemoglobin type A in normal subjects was 77.7±54.2 compared to hemoglobin type A in the D trait case (76.7 ±14.3). The mean value ± SD of hemoglobin type A2 in normal subjects was 2.7±0.3 compared to hemoglobin type A2 in the D trait case (1.1±0.3). The mean value ± SD of hemoglobin F in normal subjects was 0.4±0.4 compared to hemoglobin F in the D trait case (1.05±0.5).