Abnormal Hemoglobins | Ask Hematologist | Understand Hematology (2022)

Abnormal hemoglobins are also known as Hemoglobinopathy, Hemoglobin Variants, Hemoglobin S, Sickle Cell Disease, Hemoglobin C Disease, Hemoglobin E Disease, Thalassemia, Hemoglobin Barts, Hereditary Persistence of Fetal Hemoglobin HPFH.

Hemoglobin is a carrier for oxygen from the lungs to the various tissues and carbon dioxide from other parts of the body to the lungs. About 70% of the body’s iron is present in the red blood cells in the form of hemoglobin. Hemoglobin is an iron-protein complex that gives red blood cells its red color.It is made up of heme, which is the iron-containing portion, and globin chains, which are proteins. The globin protein consists of chains of amino acids, the “building blocks” of proteins.

There are several different types of globin chains, named alpha, beta, delta, and gamma.

Normal hemoglobin types include:

  • Hemoglobin A1 (Hb A1 or Hb A): makes up about 95%-98% of hemoglobin found in adults; it contains two alpha (α) chains and two beta (β) protein chains.
  • Hemoglobin A2 (Hb A2): makes up about 2%-3% of hemoglobin found in adults; it has two alpha (α) and two delta (δ) protein chains.
  • Hemoglobin F (Hb F, fetal hemoglobin): makes up to 1%-2% of hemoglobin found in adults; it has two alpha (α) and two gamma (γ) protein chains. It is the primary hemoglobin produced by the fetus duringpregnancy; its production usually falls shortly after birth and reaches adult level within 1-2 years.

Genetic changes (mutations) in the globingenescause alterations in the globin protein, resulting in structurally altered hemoglobin, such as hemoglobin S, which causessickle cell, or a decrease in globin chain production (thalassemia). In thalassemia, the reduced production of one of the globin chains upsets the balance of alpha to beta chains and causes abnormal hemoglobin to form (alpha thalassemia) or causes an increase of minor hemoglobin components, such as Hb A2 or Hb F (beta thalassemia).

Four genes code for the alpha globin chains, and two genes (each) code for the beta, delta, and gamma globin chains. Mutations may occur in either the alpha or beta globin genes. The most common alpha-chain-related condition is alpha thalassemia. The severity of this condition depends on the number of genes affected.

Mutations in the beta gene are mostly inherited in an autosomalrecessivefashion. This means that the person must have two altered gene copies, one from each parent, to have a hemoglobin variant-related disease. If one normal beta gene and one abnormal beta gene are inherited, the person isheterozygousfor the abnormal hemoglobin, known as acarrier. The abnormal gene can be passed on to any children, but it generally does not cause symptoms or significant health concerns in the carrier.

If two abnormal beta genes of the same type are inherited, the person ishomozygous. The person would produce the associated hemoglobin variant and may have some associated symptoms and potential for complications. The severity of the condition depends on the genetic mutation and varies from person to person. A copy of the abnormal beta gene would be passed on to any children.

If two abnormal beta genes of different types are inherited, the person is “doubly heterozygous” or “compound heterozygous”. The affected person would typically have symptoms related to one or both of the hemoglobin variants that he or she produces. One of the abnormal beta genes would be passed on to children.

Red blood cells containing abnormal hemoglobin may not carry oxygen efficiently and may be broken down by the body sooner than usual (a shortened survival), resulting inhemolytic anemia. Several hundred hemoglobin variants have been documented, but only a few are common and clinically significant. Some of the most common hemoglobin variants include hemoglobin S, the primary hemoglobin in people with sickle cell disease that causes the red blood cell to become misshapen (sickle), decreasing the cell’s survival; hemoglobin C, which can cause a minor amount of hemolytic anemia; and hemoglobin E, which may cause no symptoms or generally mild symptoms.

A hemoglobin abnormality is a variant form of hemoglobin that is often inherited and may cause a blood disorder (hemoglobinopathy).

Hemoglobin Variants:

Several hundred abnormal forms of hemoglobin (variants) have been identified, but only a few are common and clinically significant.

Common hemoglobin variants

  • Hemoglobin S: this is the primary hemoglobin in people withsickle cell disease (also known as sickle cell anemia). Approximately 1 in 375 African American babies are born with sickle cell disease, and about 100,000 Americans live with the disorder, according to the Centers for Disease Control and Prevention. Those with Hb S disease have two abnormal beta chains and two normal alpha chains. The presence of hemoglobin S causes the red blood cell to deform and assume a sickle shape when exposed to decreased amounts of oxygen (such as might happen when someone exercises or has an infection in the lungs). Sickled red blood cells are rigid and can block small blood vessels, causing pain, impaired circulation, and decreased oxygen delivery, as well as shortened red cell survival. A single beta (βS) copy (known as sickle cell trait, which is present in approximately 8% of African Americans) typically does not cause significant symptoms unless it is combined with another hemoglobin mutation, such as that causing Hb C or beta-thalassemia.
  • Hemoglobin C: about 2-3% of African Americans in the United Statesareheterozygotesfor hemoglobin C (have one copy, known as hemoglobin C trait) and are oftenasymptomatic. Hemoglobin C disease (seen inhomozygotes, those with two copies) is rare (0.02% of African Americans) and relatively mild. It usually causes a minor amount ofhemolytic anemia and a mild to moderate enlargement of the spleen.
  • Hemoglobin E: Hemoglobin E is one of the most common beta chain hemoglobin variants in the world. It is very prevalent in Southeast Asia, especially in Cambodia, Laos, and Thailand, and in individuals of Southeast Asian descent. People who are homozygous for Hb E (have two copies of βE) generally have mild hemolytic anemia, microcytic red blood cells, and mild enlargement of the spleen. A single copy of the hemoglobin E gene does not cause symptoms unless it is combined with another mutation, such as the one for beta-thalassemia trait.

Less common hemoglobin variants

(Video) Abnormal hemoglobin /# hematology /#pathology /#physiology /#Biology

There are many other variants. Some are silent – causing no signs or symptoms – while others affect the functionality and/or stability of the hemoglobin molecule. Examples of other variants include Hemoglobin D, Hemoglobin G, Hemoglobin J, Hemoglobin M, and Hemoglobin Constant Spring caused by a mutation in the alpha globin gene that results in an abnormally long alpha (α) chain and an unstable hemoglobin molecule. Additional examples include:

  • Hemoglobin F: Hb F is the primary hemoglobin produced by the fetus, and its role is to transport oxygen efficiently in a low oxygen environment. Production of Hb F decreases sharply after birth and reaches adult levels by 1-2 years of age. Hb F may be elevated in several congenital disorders. Levels can be normal to significantly increased in beta-thalassemia and are frequently increased in individuals with sickle cell anemia and in sickle cell-beta thalassemia. Individuals with sickle cell disease and increased Hb F often have a milder disease, as the F hemoglobin inhibits sickling of the red cells. Hb F levels are also increased in a rare condition called hereditary persistence of fetal hemoglobin (HPFH). This is a group of inherited disorders in which Hb F levels are increased without the signs or clinical features of thalassemia. Different ethnic groups have different mutations causing HPFH. Hb F can also be increased in some acquired conditions involving impaired red blood cell production. Someleukemiasand othermyeloproliferative neoplasms are also associated with mild elevation in Hb F.
  • Hemoglobin H: Hb H is an abnormal hemoglobin that occurs in some cases of alpha thalassemia. It is composed of four beta (β) globin chains and is produced due to a severe shortage of alpha (α) chains. Although each of the beta (β) globin chains is normal, the tetramer of 4 beta chains does not function normally. It has an increased affinity for oxygen, holding onto it instead of releasing it to the tissues and cells. Hemoglobin H is also associated with a significant breakdown of red blood cells (hemolysis) as it is unstable and tends to form solid structures within red blood cells. Serious medical problems are not common in people with hemoglobin H disease, though they often have anemia.
  • Hemoglobin Barts: Hb Barts develops in fetuses with alpha thalassemia. It is formed of four gamma (γ) protein chains when there is a shortage of alpha chains, in a manner similar to the formation of Hemoglobin H. If a small amount of Hb Barts is detected, it usually disappears shortly after birth due to dwindling gamma chain production. These children have one or two alpha gene deletionsand are silentcarriersor have the alpha thalassemia trait. If a child has a large amount of Hb Barts, he or she usually has hemoglobin H disease and a three-gene deletion. Fetuses with four-gene deletions have hydrops fetalis and usually do not survive without blood transfusions and bone marrow transplants.

A person can also inherit two different abnormalgenes, one from each parent. This is known as being compound heterozygous or doubly heterozygous. Several different clinically significant combinations are listed below.

  • Hemoglobin SC disease: inheritance of one beta S gene and one beta C gene results in Hemoglobin SC disease. These individuals have a mild hemolytic anemia and moderate enlargement of the spleen. Persons with Hb SC disease may develop the same vaso-occlusive (blood vessel-blocking) complications as seen in sickle cell anemia, but most cases are less severe.

The morphology of Hb SC is quite characteristic. Different than SS or CC

  • Sickle Cell – Hemoglobin D disease: individuals with sickle cell – Hb D disease have inherited one copy of hemoglobin S and one of hemoglobin D-Los Angeles (or D-Punjab) genes. These people may have occasional sickle crises and moderate hemolytic anemia.
  • Hemoglobin E – beta thalassemia: individuals who are doubly heterozygous for hemoglobin E and beta thalassemia have an anemia that can vary in severity, from mild (or asymptomatic) to severe, dependent on the beta thalassemia mutation(s) present.
  • Hemoglobin S – beta thalassemia: sickle cell – beta thalassemia varies in severity, depending on the beta thalassemia mutation inherited. Some mutations result in decreased beta globin production (beta+) while others completely eliminate it (beta0). Sickle cell – beta+thalassemia tends to be less severe than sickle cell – beta0thalassemia. People with sickle cell – beta0thalassemia tend to have more irreversibly sickled cells, more frequent vaso-occlusive problems, and more severe anemia than those with sickle cell – beta+thalassemia. It is often difficult to distinguish between sickle cell disease and sickle cell – beta0thalassemia.

Signs and Symptoms:

Signs and symptoms associated with hemoglobin variants can vary in type and severity depending on the variant present and whether an individual has one variant or a combination. Some are the result of an increase in the breakdown (hemolysis) of red blood cells and a shortened RBC survival, leading toanemia. Some examples include:

  • Weakness, fatigue
  • Lack of energy
  • Jaundice
  • Pale skin (pallor)

Some serious signs and symptoms include:

  • Episodes of severe pain e.g. sickle cell anemia
  • Shortness of breath
  • Enlarged spleen
  • Growth problems in children
  • Upper abdomen pain (due to stone formation in the gallbladder)

Abdominal ultrasonography showing biliary sludge and gallstones

(Video) Hematology - Complete Blood Count (CBC) - Critical Care Labs

Testing for hemoglobin abnormalities (variants) is done:

  • To screen for common and clinically significant hemoglobin variants in newborns. In all states, this has become a standard part ofnewborn screening. Infants with variants such as Hb S can benefit from early detection and treatment.
  • As part ofprenatal screening, on high-risk women including those with an ethnic background associated with a higherprevalenceof hemoglobin variants (such as those of African descent) and those with affected family members. Screening may also be done in conjunction withgenetic counselingprior topregnancyto determine possiblecarrier status of potential parents.
  • To identify variants inasymptomatic parents with an affected child.
  • To identify hemoglobin variants in those with symptoms of unexplainedanemia, with red blood cells (RBCs) that are small and/or paler than normal (microcytosisandhypochromia). It may also be ordered as part of an anemia investigation, or when someone has signs and symptoms associated with hemoglobin variants.

A stillborn fetus with alpha thalassemia major has the appearance on peripheral blood smear shown here. Note that predominantly hemoglobin Bart’s results in marked anisocytosis and poikilocytosis of RBC’s, with expansion of erythropoiesis and presence of many immature RBC’s in the peripheral blood, as evidenced by polychromasia, nucleated RBC’s and even erythroblasts seen here.

Laboratory tests

  • CBC (complete blood count): The CBC is a snapshot of the cells circulating in the blood. Among other things, the CBC will tell the doctor how many red blood cells are present, how much hemoglobin is in them, and give the doctor an evaluation of the average size of the red blood cells present. Mean corpuscular volume (MCV) is a measurement of the size of the red blood cells. A low MCV is often the first indication ofthalassemia. If the MCV is low and iron-deficiency has been ruled out, the person may be a carrier of the thalassemia trait or have a hemoglobin variant that results in smaller than normal RBCs (for example, Hb E).
  • Blood smear(also called a peripheral smear): In this test, a trained laboratorian looks under the microscope at a thin layer of blood on a slide treated with a special stain. The number and type of white blood cells, red blood cells, and platelets can be evaluated to see if they are normal and mature. With ahemoglobinopathy, the red blood cells may be:
    • Smaller than normal (microcytic)
    • Paler than normal (hypochromic)
    • Varying in size (anisocytosis) and shape (poikilocytosis, e.g., sickle-shaped cells)
    • Having anucleus(nucleated red blood cell, not normal in a mature RBC) or crystal (e.g., C crystal)
    • Having uneven hemoglobin distribution (producing “target cells” that look like a bull’s-eye under the microscope).

    The greater the percentage of abnormal-looking red blood cells, the greater the likelihood of an underlying disorder.

  • Hemoglobinopathy evaluation: These tests identify the type, and measure the relative amount of the different types of hemoglobin present in an individual’s red blood cells. Most of the common variants can be identified using one of these tests or a combination. The relative amounts of any variant hemoglobin detected can help diagnose combinations of hemoglobin variants and thalassemia (compound heterozygotes).
  • Hemoglobin electrophoresis is used as a screening test to identify normal and abnormal hemoglobins and assess their quantity. Hemoglobin typesinclude hemoglobin A1(HbA1), hemoglobin A2(HbA2), hemoglobin F (HbF; fetal hemoglobin), hemoglobin C (HbC), and hemoglobin S (HbS).Hemoglobin reference ranges are as follows.

Adult/elderly: Percentage of total Hb:

  • HbA1: 95-98%
  • HbA2: 2-3%
  • HbF: 0.8-2%
  • HbS: 0%
  • HbC: 0%
  • HbE: 0%

Children: HbF:

  • Newborn: 50-80%
  • < 6months: < 8%
  • >6 months: 1-2%
  • Genetic testing: These tests areused to investigate deletions and mutations in the alpha and beta globin-producing genes. Family studies can be done to evaluate carrier status and the types of mutations present in other family members. Genetic testing is not routinely done but can be used to help confirm hemoglobin variants, thalassemia, and to determine carrier status.

Hemoglobin variants are rarely cured. The main goals in treating hemoglobin variants include relieving pain, minimizing complications and organ damage, and preventing infections. Children with sickle cell diseaseshould have regular childhoodvaccinationsandinfluenzavaccination.

Treatment during a sickle cell crisis may involve hospitalization and supportive care, including drinking lots of fluids and taking pain medication. Sometimes blood transfusions are needed to treat severeanemia. Antibiotics are needed if sickle crisis is triggered by infection (e.g.,pneumonia).

Individuals with hemoglobin variants can minimize crises by avoiding or managing situations likely to trigger episodes. These situations include overexertion, dehydration, extreme temperatures, altitude changes, smoking, and stress.

Drugs that increase hemoglobin F are available. These drugs (e.g., hydroxyurea) relieve some symptoms, but research into safer and more effective therapy continues. L-glutamine has been approved for use to reduce severe complications of sickle cell anemia. Bone marrow or stem cell transplants from a family member with normal hemoglobin are known to cure sickle cell disease. These treatments are risky and have severe side effects, so they remain rare. Gene therapy to correct the mutated gene is beginning to show promise in small trials, but it will require much more research before it is considered for widespread use.

(Video) Hematology - 2 | U1-L22 | Abnormal hemoglobins

Hemoglobin Abnormalities | Lab Tests Online https://labtestsonline.org/conditions/hemoglobin-abnormalities

Sickle cell disease – GeneticsHomeReference. https://go.usa.gov/x8VbM

Dr Pooja Chhawcharia – Hemoglobin levels and its significance. https://blog.ekincare.com/2016/07/20/hemoglobin-levels-and-its-significance

Kyle Bradley, MD. Classic example of hemoglobin SC disease.https://twitter.com/KyleBradleyMD/status/758044602297413633

Lin IH, Tsai YH, Ho JL, Kuok CM (2019) Hb Bart’s Hydrops Fetalis. J Urol Ren Dis 11: 1143.

Shaffer, E. A. (2001). “Gallbladder sludge: What is its clinical significance?”.Current gastroenterology reports.3(2): 166–73.

Hemoglobinopathies. http://ar.utmb.edu/webpath/tutorial/hgb/hgb40.htm

Teresa Scordino, MD.ASH Image Bank: https://imagebank.hematology.org/image/60269/hemoglobin-c-crystals-and-target-cells

Pagana KD, Pagana TJ, Pagana TN.Mosby’s Diagnostic & Laboratory Test Reference. 14th ed. St. Louis, Mo: Elsevier; 2019.

Bishnu Prasad Devkota, MD. Hemoglobin Electrophoresis: Reference Range, Interpretation, Collection and Panels https://emedicine.medscape.com/article/2085637-overview


Abnormal Hemoglobins | Ask Hematologist | Understand Hematology (9)

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Abnormal Hemoglobins


Abnormal hemoglobins are also known as Hemoglobinopathy, Hemoglobin Variants, Hemoglobin S, Sickle Cell Disease, Hemoglobin C Disease, Hemoglobin E Disease, Thalassemia, Hemoglobin Barts, Hereditary Persistence of Fetal Hemoglobin HPFH.


Dr Moustafa Abdou

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Abnormal Hemoglobins | Ask Hematologist | Understand Hematology (10)


What are abnormal hemoglobin S? ›

If levels of HgbA or HgbF are too high or too low, it can indicate certain types of anemia. Abnormal types of hemoglobin include: Hemoglobin (Hgb) S. This type of hemoglobin is found in sickle cell disease. Sickle cell disease is an inherited disorder that causes the body to make stiff, sickle-shaped red blood cells.

What is the most common cause of abnormal hemoglobin? ›

Sickle Cell Anemia – The Most Common Hemoglobin Disease

Sickle cell anemia is one of the most frequently occurring genetic disorders that affect the red blood cells.

Why is hemoglobin abnormal? ›

Abnormal hemoglobins result from mutations that change the sequence or number of nucleotides within the globin gene involved, or more rarely, from mispairing and crossover between two like genes during meiosis, creating a fusion protein of both gene sequences.

What are the different types of hemoglobin S? ›

Many different types of hemoglobin (Hb) exist. The most common ones are HbA, HbA2, HbE, HbF, HbS, HbC, HbH, and HbM. Healthy adults only have significant levels of only HbA and HbA2.

What abnormal hemoglobin S are irreversible? ›

Irreversibly sickled erythrocytes: a consequence of the heterogeneous distribution of hemoglobin types in sickle-cell anemia.

What do hemoglobin S do? ›

Hemoglobin is a protein in your red blood cells that carries oxygen from your lungs to the rest of your body. If your hemoglobin levels are abnormal, it may be a sign that you have a blood disorder.

Which is an example of a clinically important abnormal hemoglobin? ›

Hemoglobin H: Hb H is an abnormal hemoglobin that occurs in some cases of alpha thalassemia. It is composed of four beta (β) globin chains and is produced due to a severe shortage of alpha (α) chains. Although each of the beta (β) globin chains is normal, the tetramer of 4 beta chains does not function normally.

Which disorder is associated with the abnormal hemoglobin proteins in the blood? ›

Sickle cell disease (SCD), an umbrella group of hemoglobinopathies that includes sickle cell anemia, is an inherited disorder caused by an abnormal form of a protein called beta-globin. This can cause red blood cells to become sickle (crescent)-shaped and inflexible.

What is the most common disorder of the red blood cells? ›

Sickle cell anemia is the most common type of inherited blood disorders. Healthy blood cells are fluid in shape so they can easily pass through the small blood vessels in the body.

What are the three types of hemoglobin? ›

Some normal hemoglobin types are; Hemoglobin A (Hb A), which is 95–98% of hemoglobin found in adults, Hemoglobin A2 (Hb A2), which is 2–3% of hemoglobin found in adults, and Hemoglobin F (Hb F), which is found in adults up to 2.5% and is the primary hemoglobin that is produced by the fetus during pregnancy.

What disease is the opposite of leukemia? ›

Polycythemia vera (pol-e-sy-THEE-me-uh VEER-uh) is a type of blood cancer. It causes your bone marrow to make too many red blood cells. These excess cells thicken your blood, slowing its flow, which may cause serious problems, such as blood clots. Polycythemia vera is rare.

In which of the following conditions would you find structurally abnormal hemoglobin? ›

Conditions like sickle cell anemia and thalassemia can cause hemoglobin to have an abnormal structure.

Can all abnormal hemoglobins be diagnosed by electrophoresis? ›

Patients should be screened with a hemoglobin electrophoresis which is able to detect not only the abnormal hemoglobin S of sickle cell anemia, but also other abnormal hemoglobin variants which may cause disease. Solubility testing such as the Sickledex is not sufficient.

How can a blood test detect thalassemia? ›

Your healthcare provider may order various blood tests to diagnose thalassemia: A complete blood count (CBC) that includes measures of hemoglobin and the quantity (and size) of red blood cells. People with thalassemia have fewer healthy red blood cells and less hemoglobin than normal.

What is the most common type of hemoglobin in adults? ›

The most common types of normal hemoglobin are: Hemoglobin A. This is the most common type of hemoglobin found normally in adults. Some diseases, such as severe forms of thalassemia, may cause hemoglobin A levels to be low and hemoglobin F levels to be high.

What is the rarest type of anemia? ›

There are three types of CDA, type 1, 2 and 3. Type 2 is the most common and type 3 is the rarest. Symptoms include chronic anemia, fatigue, jaundice and yellow eyes, pale skin, and no fingers and toes at birth.

Where are hemoglobins made? ›

Hemoglobin develops in cells in the bone marrow that become red blood cells.

What happens in thalassemia disease? ›

Thalassemia (thal-uh-SEE-me-uh) is an inherited blood disorder that causes your body to have less hemoglobin than normal. Hemoglobin enables red blood cells to carry oxygen. Thalassemia can cause anemia, leaving you fatigued. If you have mild thalassemia, you might not need treatment.

How a person with haemoglobin S would be affected? ›

Hgb S causes red blood cells to become stiff and abnormally shaped. Instead of having a normal round, disk shape, these red blood cells become sickle-shaped, or crescent-shaped.

What level of hemoglobin is concerning? ›

What hemoglobin levels are considered severe or dangerously low? A hemoglobin level of less than 5.0 grams per deciliter (g/dl) is dangerous and could lead to heart failure or death. A normal hemoglobin level is 13.2–16.6 grams per deciliter (g/dL) for males and 11.6–15 g/dL for females.

What are the 4 types of hemoglobin? ›

Four different hemoglobin species are commonly recognized: oxyhemoglobin (oxy-Hb), deoxyhemoglobin (deoxy-Hb), methemoglobin (met-Hb), and hemichromes, whose structures appear below.

What genetic disorders affect red blood cells? ›

Genetic abnormalities affecting hemoglobin include the sickling disorders, the unstable hemoglobinopathies, hemoglobinopathies associated with polycythemia or with methemoglobinemia, and the α- and β-thalassemias.

What are the most common diseases that affect blood? ›

Common blood disorders include anemia, bleeding disorders such as hemophilia, blood clots, and blood cancers such as leukemia, lymphoma, and myeloma. Talking to your doctor is the first step to take if you believe you may have a blood condition.

Is it serious to be referred to a hematologist? ›

No, seeing a hematologist doesn't mean you have cancer. Hematologists treat all kinds of blood diseases. You may see a hematologist if your primary care provider recommends you see a specialist because your blood tests show abnormal blood cell count or coagulation levels.

Why would a doctor refer you to a hematologist? ›

Why am I being referred to a hematologist? If your primary care physician is referring you to a hematologist, it may be because you are at risk for a condition involving your red or white blood cells, platelets, blood vessels, bone marrow, lymph nodes, or spleen.

Why would you be referred to a hematologist? ›

Reasons include if you have or might have: Anemia, or low red blood cells. Deep vein thrombosis (blood clots) Leukemia, lymphoma, or multiple myeloma (cancers in your bone marrow, lymph nodes, or white blood cells)

Can thalassemia be cured? ›

Stem cell or bone marrow transplants are the only cure for thalassaemia, but they're not done very often because of the significant risks involved. Stem cells are produced in bone marrow, the spongy tissue found in the centre of some bones, and have the ability to develop into different types of blood cells.

What is thalassemia test? ›

If your doctor suspects your child has thalassemia, he or she can confirm a diagnosis with blood tests. Blood tests can reveal the number of red blood cells and abnormalities in size, shape or color. Blood tests can also be used for DNA analysis to look for mutated genes.

What could low hemoglobin mean? ›

Low hemoglobin levels usually indicate that a person has anemia. There are several kinds of anemia: Iron-deficiency anemia: This is the most common type that can occur when a person does not have enough iron in their body, and it cannot make the hemoglobin the body needs.

Does Covid vaccine affect red blood cell count? ›

Partial vaccination did not alleviate the anemia, but fully vaccinated patients demonstrated higher RBC counts and lower RDWs with significance, albeit the patient ratios with deranged hematological data showed no difference from those without vaccination.

What cancers cause high red blood cell count? ›

What cancers cause high red blood cell count?
  • Polycythemia vera (a rare blood cancer that causes your body to make too many red blood cells).
  • Renal cell carcinoma (the most common type of kidney cancer among adults).
  • Hepatocellular carcinoma (the most common type of liver cancer among adults).
25 Apr 2022

Does leukemia cause itching? ›

When immune cells come into contact with leukaemia or lymphoma cells, they can release cytokines at high levels, causing irritation of nerve endings within the skin and thereby a persistent itch.

What does abnormally large red blood cells mean? ›

Macrocytic anemia is a blood disorder that happens when your bone marrow produces abnormally large red blood cells. These abnormal blood cells lack nutrients red blood cells need to function normally. Macrocytic anemia isn't a serious illness but it can cause serious medical issues if left untreated.

How do you know if you have a blood disorder? ›

How are blood cell disorders diagnosed? Your doctor may order several tests, including a complete blood count (CBC) to see how many of each type of blood cell you have. Your doctor may also order a bone marrow biopsy to see if there are any abnormal cells developing in your marrow.

Why would red blood cells be enlarged? ›

It is associated with anemia, when you also have insufficient numbers of properly functioning red blood cells. Macrocytosis is usually caused by low vitamin B12 or folate levels, but there are other reasons it develops, including from liver disease, alcoholism, and from taking certain medications.

What level of hemoglobin is concerning? ›

What hemoglobin levels are considered severe or dangerously low? A hemoglobin level of less than 5.0 grams per deciliter (g/dl) is dangerous and could lead to heart failure or death. A normal hemoglobin level is 13.2–16.6 grams per deciliter (g/dL) for males and 11.6–15 g/dL for females.

What is the difference between hemoglobin A and S? ›

Hemoglobin S is an inherited variant of normal adult hemoglobin (hemoglobin A). It results from a substitution of valine for glutamic acid in the sixth position of the beta (β) globin chain. The gene for Hemoglobin S has the highest frequency among people of African heritage (about 1 in 10).

What is a positive sickle test? ›

A screening test result that is positive for sickle cell trait means that your baby's blood has both normal cells as well as sickle cells in their blood. You may have heard about sickle cell anemia. Sickle cell anemia and sickle cell disease are very different from sickle cell trait.

What level of hemoglobin is dangerously high? ›

The threshold for a high hemoglobin count differs slightly from one medical practice to another. It's generally defined as more than 16.6 grams (g) of hemoglobin per deciliter (dL) of blood for men and 15 g/dL for women.

Does drinking water lower hemoglobin? ›

A steady intake of water increases hemoglobin indices, such as the MCH and MCHC, and decreases the MPV. As shown in Table 1, at the end of the study period, WBC, RBC, and platelet counts increased in the experimental group, as did hematocrit and hemoglobin levels, although the increases were not significant ( p >0.05).

What is the lowest hemoglobin level you can live with? ›

To the best of our knowledge, 0.6 g/dL is the lowest hemoglobin value ever observed in an anesthetized patient who survived.

What is a healthy hemoglobin level by age? ›

1-6 years: 9.5-14 g/dL. 6-18 years: 10-15.5 g/dL. Adult men: 14-18 g/dL. Adult women: 12-16 g/dL.

How a person with Haemoglobin S would be affected? ›

Hgb S causes red blood cells to become stiff and abnormally shaped. Instead of having a normal round, disk shape, these red blood cells become sickle-shaped, or crescent-shaped.

What is the most common blood disease? ›

Common blood disorders include anemia, bleeding disorders such as hemophilia, blood clots, and blood cancers such as leukemia, lymphoma, and myeloma.

Which is worse sickle cell SS and SC? ›

Hemoglobin SC disease

Individuals with Hb SC have similar symptoms to individuals with Hb SS. However, the anemia is less severe.

What labs are abnormal with sickle cell anemia? ›

Baseline Blood Study Abnormalities
  • Hemoglobin level is 5-9 g/dL.
  • Hematocrit is decreased to 17-29%
  • Total leukocyte count is elevated to 12,000-20,000 cells/mm3 (12-20 X 109/L), with a predominance of neutrophils.
  • Platelet count is increased.
  • Erythrocyte sedimentation rate is low.
2 Nov 2021

Can a person with sickle cell trait have pain? ›

Some adolescents and adults with sickle cell anemia also have chronic pain, which can result from bone and joint damage, ulcers, and other causes. Swelling of hands and feet. The swelling is caused by sickle-shaped red blood cells blocking blood circulation in the hands and feet.

Is sickle cell trait serious? ›

People with sickle cell disease produce unusually shaped red blood cells that can cause problems because they do not live as long as healthy blood cells and can block blood vessels. Sickle cell disease is a serious and lifelong health condition, although treatment can help manage many of the symptoms.

Should I worry if my hemoglobin is high? ›

If you have a high hemoglobin count without other abnormalities, it's unlikely to indicate a related serious condition. Conditions that can cause a high hemoglobin count include: Congenital heart disease in adults. COPD (chronic obstructive pulmonary disease) worsening of symptoms.

Can anxiety cause high hemoglobin? ›

Results: Higher hemoglobin levels were found in those with current depressive and/or anxiety disorders after sociodemographic adjustment and both higher, and lower hemoglobin levels were found in persons with higher depression and anxiety severity.

What is the treatment for high hemoglobin? ›

How is high hemoglobin count treated? Treatment for high hemoglobin count varies depending on the underlying cause. In some cases, your healthcare provider may recommend a phlebotomy. In a phlebotomy, a healthcare provider inserts a needle into one of your veins and removes extra red blood cells.


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