Hematologic Characteristics and Hemoglobin Fraction Analysis by High Performance Liquid Chromatogaphy in Patients with Hypochromic Microcytosis: Trials for Detection of beta-thalassemia

Background : In Korea, more than 20 cases of -thalassemia have been reported up to date. To detect -thalassemia. Hemoglobin (Hb) fractions were measured in patients with hypochromic microcytosis, and we analyzed the hematological characteristics of these patients. Methods : Among 359,369 CBCs performed at Asan Medical Center, 229 patients (0.064%) showed hypochromic microcytosis with less than 75 fL of mean corpuscular volume (MCV), less than 24 pg of mean corpuscular hemoglobin (MCH), and less than 18% of red cell distribution width (RDW). We analysed Hb fractions using high performance liquid chromatography ( Hemoglobin Testing System). Iron, total iron binding capacity (TIBC), ferritin, and reticulocyte counts were measured and medical history was searched on cases with Hb and F fractions more than 3.5% and 2.0%, respectively. Results : Among the 229 patients with hypochromic microcysis, 44 (19.2%) showed an increased level of Hb and/or F fractions. With the exclusion of 28 patients (23 children and/or F. However, all 16 patients were diagnosed as having iron deficiency anemia based on their iron status and clinical findings. Three patients who had an increased level of Hb F at more than 5% needed a further study and follow-up to rule out the diagnosis of the hereditary persistence of the fetal hemoglobin. Conclusions : No thalassemia cases were found in the study. Incidence of -thalassemia should be very low, less than 1/359,369 (0.00027%), in South Korea; a larger population should be screened to detect -thalassemia.