Emeka Patrick Chukwuka: The Numbers Don’t Lie, But Context Matters
Emeka Patrick Chukwuka, Hematologist and Clinical Pathologist, shared a post on LinkedIn:
“Clinical Haematology Education Series – Teaching Case 03
A 42-year-old male with confirmed homozygous sickle cell disease (Hb SS) attended routine haematology review. Serial HPLC over 10 months told a story that almost changed his diagnosis — until the transfusion record was checked.
The finding: Hb A, which should be absent in true Hb SS, reappeared — jumping from 0% to 24.3%, then falling back to 9.1% over approximately nine weeks.
The question every haematologist must ask: Is this a co-inherited β⁺-thalassaemia allele making this Hb S/β⁺-thal — or is this transfused donor blood clearing from circulation?
The answer lies in the trajectory.
- A genotypic Hb A fraction (as in Hb S/β⁺-thal) is proportionally stable visit to visit — it doesn’t spike and decay.
- A transfusion-derived Hb A follows the donor red cell lifespan (~120 days) — a sharp rise, then a gradual fall as donor cells senesce. Here, the 0% to 24.3% and then to 9.1% curve fits transfusion kinetics precisely. The timing correlated with a red cell transfusion 2–8 weeks prior.
The teaching pearl: In confirmed Hb SS, Hb A on HPLC or electrophoresis is transfusion-derived until the blood bank record proves otherwise — never a standalone basis for reclassifying genotype.
Practical implications are significant: Do not reclassify Hb SS as a compound heterozygote on electrophoresis alone.
Defer %HbS/%HbF targets for hydroxyurea or exchange transfusion until more than 3 months post-transfusion.
Always correlate HPLC with transfusion history before signing out the report
This case is a reminder that laboratory context is clinical context. The numbers don’t lie — but they do require the right question.”
Stay updated with Hemostasis Today.
-
Sep 12, 2026, 07:02Melissa Hollo: Pre-Operative Anemia – An Underrecognized Challenge in Surgical Care
-
Sep 12, 2026, 06:57Klaus Metzeler: ESH 2026 MDS Conference – Connecting Experts Across Hematology
-
Sep 12, 2026, 06:40Lakmali Silva: Fibrinolysis and Its Role in Hematopoietic Recovery After Chemotherapy
-
Sep 12, 2026, 06:30Alexander Misono: Improving DVT Diagnosis and Care Through Venous Duplex Ultrasound
-
Sep 12, 2026, 06:06Simone Cesaro: GNE-Related Thrombocytopenia – New Findings
-
Sep 12, 2026, 04:11Jyotishbhai Patel: Why India Needs Universal Newborn Screening for Sickle Cell and Thalassemia
-
Sep 12, 2026, 04:04Oliver Schlager: New ESC and ESVM Clinical Consensus on Lipid-Lowering Therapy in VTE
-
Sep 12, 2026, 03:54Toby Richards: Representing IronLife at Parliament on Anaemia and Iron Deficiency
-
Sep 12, 2026, 03:50Saleh Shamse Basha: When ‘Low Protein S’ Isn’t Necessarily Low