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Hemoglobin Electrophoresis

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What is hemoglobin electrophoresis?

Haemoglobin is a protein in your red blood cells that carries oxygen from your lungs to the rest of your body. There are several different types of haemoglobin. Haemoglobin electrophoresis is a test that measures the different types of haemoglobin in the blood. It also looks for abnormal types of haemoglobin.

Normal types of hemoglobin include:

  • Haemoglobin (Hgb) A, the most common type of haemoglobin in healthy adults
  • Haemoglobin (Hgb) F, fetal haemoglobin. This type of haemoglobin is found in unborn babies and newborns. HgbF is replaced by HgbA shortly after birth.

If levels of HgbA or HgbF are too high or too low, it can indicate certain types of anemia.

Abnormal types of hemoglobin include:

  • Haemoglobin (Hgb) S. This type of haemoglobin 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. Healthy red blood cells are flexible so they can move easily through blood vessels. Sickle cells can get stuck in the blood vessels, causing severe and chronic pain, infections, and other complications.
  • Haemoglobin (Hgb) C. This type of haemoglobin does not carry oxygen well. It can cause a mild form of anaemia.
  • Haemoglobin (Hgb) E. This type of haemoglobin is mostly found in people of Southeast Asian descent. People with HgbE usually have no symptoms or mild symptoms of anaemia.

A haemoglobin electrophoresis test applies an electric current to a blood sample. This separates normal and abnormal types of haemoglobin. Each type of haemoglobin can then be measured individually.

Other names: Hb electrophoresis, hemoglobin evaluation, hemoglobinopathy evaluation, hemoglobin fractionation, Hb ELP, sickle cell screen

What is it used for?

Hemoglobin electrophoresis measures hemoglobin levels and looks for abnormal types of hemoglobin. It’s most often used to help diagnose anemia, sickle cell disease, and other hemoglobin disorders.

Why do I need haemoglobin electrophoresis?

You may need testing if you have symptoms of a hemoglobin disorder. These include:

  • Fatigue
  • Pale skin
  • Jaundice, a condition that causes your skin and eyes to turn yellow
  • Severe pain (sickle cell disease)
  • Growth problems (in children)
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If you’ve just had a baby, your newborn will be tested as part of newborn screening. Newborn screening is a group of tests given to most American babies shortly after birth. The screening checks for a variety of conditions. Many of these conditions can be treated if found early.

You may also want testing if you are at risk for having a child with sickle cell disease or another inherited hemoglobin disorder. Risk factors include:

  • Family history
  • Ethnic background
    • In the United States, most people with sickle cell disease are of African ancestry.
    • Thalassemia, another inherited haemoglobin disorder, is most common among people of Italian, Greek, Middle Eastern, Southern Asian, and African descent.

What happens during hemoglobin electrophoresis?

A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

To test a newborn, a health care provider will clean your baby’s heel with alcohol and poke the heel with a small needle. The provider will collect a few drops of blood and put a bandage on the site.

Will I need to do anything to prepare for the test?

You don’t need any special preparations for a hemoglobin electrophoresis test.

Are there any risks to hemoglobin electrophoresis?

There is very little risk of having a blood test. You may have slight pain or bruise at the spot where the needle was put in, but most symptoms go away quickly.

Your baby may feel a little pinch when the heel is poked, and a small bruise may form at the site. This should go away quickly.

What do the results mean?

Your results will show the types of hemoglobin found and the levels of each.

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Hemoglobin levels that are too high or too low may mean:

  • Thalassemia, a condition that affects the production of haemoglobin. Symptoms range from mild to severe.
  • Sickle cell trait. In this condition, you have one sickle cell gene and one normal gene. Most people with sickle cell trait do not have health problems.
  • Sickle cell disease
  • Haemoglobin C disease, a condition that causes a mild form of anaemia and sometimes an enlarged spleen and joint pain
  • Haemoglobin S-C disease, a condition that causes a mild or moderate form of sickle cell disease

Your results may also show whether a specific disorder is mild, moderate, or severe.

Haemoglobin electrophoresis test results are often compared with other tests, including a complete blood count and a blood smear. If you have questions about your results, talk to your health care provider.

Is there anything else I need to know about haemoglobin electrophoresis?

If you are at risk of having a child with an inherited haemoglobin disorder, you may want to speak to a genetic counsellor. A genetic counsellor is a specially trained professional in genetics and genetic testing. He or she can help you understand the disorder and your risk of passing it along to your child.

References

  1. American Society of Hematology [Internet]. Washington D.C.: American Society of Hematology; c2020. Sickle Cell Disease; [cited 2020 Jan 10]; [about 3 screens]. Available from: https://www.hematology.org/Patients/Anemia/Sickle-Cell.aspx
  2. Cleveland Clinic [Internet]. Cleveland (OH): Cleveland Clinic; c2020. Sickle Cell Anemia: Overview; [cited 2020 Jan 10]; [about 3 screens]. Available from: https://my.clevelandclinic.org/health/diseases/4579-sickle-cell-anemia
  3. Kids Health from Nemours [Internet]. Jacksonville (FL): The Nemours Foundation; c1995–2020. Blood Test: Hemoglobin Electrophoresis; [cited 2020 Jan 10]; [about 3 screens]. Available from: https://kidshealth.org/en/parents/test-electrophoresis.html
  4. Lab Tests Online [Internet]. Washington D.C.: American Association for Clinical Chemistry; c2001–2020. Hemoglobinopathy Evaluation; [updated 2019 Sep 23; cited 2020 Jan 10]; [about 2 screens]. Available from: https://labtestsonline.org/tests/hemoglobinopathy-evaluation
  5. Lab Tests Online [Internet]. Washington D.C.: American Association for Clinical Chemistry; c2001–2020. Jaundice; [updated 2019 Oct 30; cited 2020 Jan 10]; [about 2 screens]. Available from: https://labtestsonline.org/conditions/jaundice
  6. March of Dimes [Internet]. Arlington (VA): March of Dimes; c2020. Newborn Screening Tests for Your Baby; [cited 2020 Jan 10]; [about 3 screens]. Available from: https://www.marchofdimes.org/baby/newborn-screening-tests-for-your-baby.aspx
  7. Merck Manual Consumer Version [Internet]. Kenilworth (NJ): Merck & Co. Inc.; 2020. Hemoglobin C, S-C, and E Diseases; [updated 2019 Feb; cited 2020 Jan 10]; [about 2 screens]. Available from: https://www.merckmanuals.com/home/blood-disorders/anemia/hemoglobin-c,-s-c,-and-e-diseases?query=hemoglobin%20electrophoresis
  8. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Blood Tests; [cited 2020 Jan 10]; [about 3 screens]. Available from: https://www.nhlbi.nih.gov/health-topics/blood-tests
  9. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Sickle Cell Disease; [cited 2020 Jan 10]; [about 3 screens]. Available from: https://www.nhlbi.nih.gov/health-topics/sickle-cell-disease
  10. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Thalassemias; [cited 2020 Jan 10]; [about 3 screens]. Available from: https://www.nhlbi.nih.gov/health-topics/thalassemias
  11. UF Health: University of Florida Health [Internet]. Gainesville (FL): University of Florida Health; c2020. Hemoglobin electrophoresis: Overview; [updated 2020 Jan 10; cited 2020 Jan 10]; [about 2 screens]. Available from: https://ufhealth.org/hemoglobin-electrophoresis
  12. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2020. Health Information: Hemoglobin Electrophoresis: Results; [updated 2019 Mar 28; cited 2020 Jan 10]; [about 8 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/hemoglobin-electrophoresis/hw39098.html#hw39128
  13. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2020. Health Information: Hemoglobin Electrophoresis: Test Overview; [updated 2019 Mar 28; cited 2020 Jan 10]; [about 2 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/hemoglobin-electrophoresis/hw39098.html
  14. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2020. Health Information: Hemoglobin Electrophoresis: What To Think About; [updated 2019 Mar 28; cited 2020 Jan 10]; [about 10 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/hemoglobin-electrophoresis/hw39098.html#hw39144
  15. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2020. Health Information: Hemoglobin Electrophoresis: Why It Is Done; [updated 2019 Mar 28; cited 2020 Jan 10]; [about 3 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/hemoglobin-electrophoresis/hw39098.html#hw39110
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