Summary
Objectives. Hemoglobinopathies (HbP) are particularly frequent in the Mediterranean countries, in the Middle East, in both West and North Africa, as well as in India and other Asian countries. Multi-ethnic migrations however, are now affecting the epidemiology of hemoglobinopathies. Non-endemic countries such as Estonia, Latvia, Lithuania are affected by thalassemia-related problems due to increasing migration from endemic to non-endemic areas. The prevalence of HbP in the Baltic Sea region is unknown. In non-endemic countries physicians need to know when to suspect and how to diagnose hemoglobinopathies.
The aim of the current study was to assess hemoglobin electrophoresis results retrospectively and define the necessary steps in the diagnostic workflow of HbP.
Methods. The current study is a retrospective analysis of 339 samples submitted for hemoglobin electrophoresis evaluation between 2011 and 2018 at the laboratory of North Estonia Medical Centre. The subjects were divided into three groups based on the HbA2 reference values (2.5-3.5%) used in our laboratory: group-1 (<2.5%), group-2 (2.5-3.5%), group-3 (>3.5%).
Results. 65 cases of hemoglobinopathy were found. As a result of this study, a standardised Information Sheet (questionnaire) was developed to be used prior to ordering the hemoglobin electrophoresis via the laboratory information system (LIS). Also, a diagnostic workflow was developed and implemented for routine use.
Conclusions. In recent decades the identification of hemoglobinopathies in non-endemic countries has become very important and requires focused attention. Interpretation of results is a complex process involving multi-step testing and multidisciplinary approach. In this context, it is important to routinely collect information necessary for interpretation and to establish standardised workflows.
