Daniel Xia 1 , Randall McShine 2 , Anders H Berg 3 Show Affiliations »
Abstract
OBJECTIVES: We report a case of a patient with diabetes mellitus and unexpectedly low hemoglobin A1c results associated with paroxysmal nocturnal hemoglobinuria (PNH). We review the impact of shortened RBC half-life on the interpretation of hemoglobin A1c levels. METHODS: Patient history and laboratory test results were obtained from electronic medical records and analyzed. RESULTS: The patient's hemoglobin A1c declined in parallel to worsening anemia after the diagnosis of PNH. However, elevated serum glucose (random), fructosamine, and glycated albumin suggest ongoing hyperglycemia. Together, these results argue that the decline in hemoglobin A1c was due to decreased RBC survival secondary to PNH. CONCLUSIONS: Hemoglobin A1c levels must be interpreted with caution in patients with hematologic diseases that change RBC survival. Serum fructosamine and glycated albumin measurements are alternative measures of time-averaged blood glucose control and may be useful in this subset of patients. Copyright© by the American Society for Clinical Pathology.
OBJECTIVES: We report a case of a patient with diabetes mellitus and unexpectedly low hemoglobin A1c results associated with paroxysmal nocturnal hemoglobinuria (PNH). We review the impact of shortened RBC half-life on the interpretation of hemoglobin A1c levels. METHODS: Patient history and laboratory test results were obtained from electronic medical records and analyzed. RESULTS: The patient 's hemoglobin A1c declined in parallel to worsening anemia after the diagnosis of PNH. However, elevated serum glucose (random), fructosamine , and glycated albumin suggest ongoing hyperglycemia . Together, these results argue that the decline in hemoglobin A1c was due to decreased RBC survival secondary to PNH. CONCLUSIONS: Hemoglobin A1c levels must be interpreted with caution in patients with hematologic diseases that change RBC survival. Serum fructosamine and glycated albumin measurements are alternative measures of time-averaged blood glucose control and may be useful in this subset of patients . Copyright© by the American Society for Clinical Pathology.
Entities: Chemical
Disease
Species
Keywords:
Anemia; Diabetes; Hemoglobin A1c; Paroxysmal nocturnal hemoglobinuria; RBC half-life; RBC survival
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Year: 2014
PMID： 25015870 DOI： 10.1309/AJCPTK1HPR2KULJU
Source DB: PubMed Journal: Am J Clin Pathol ISSN： 0002-9173 Impact factor: 2.493