Smitirupa Mishra/LinkedIn

Jun 10, 2026, 18:00

Smitirupa Mishra: Normal Hemoglobin Does Not Always Mean Normal Genes

Smitirupa Mishra, Consultant Pathologist at Sparsh Hospitals and Lab Head at Pathkind Labs, shared a post on LinkedIn:

“After reporting daily HPLCs, and seeing so many carrier states that look completely normal on a CBC…
that’s when it really struck me:

‘Normal hemoglobin does not always mean normal genes.’

Many people walk into the lab with normal hemoglobin and no symptoms – yet they silently carry hemoglobinopathies.

These ‘silent carriers’ are often detected only through HPLC/electrophoresis.

Early detection can prevent a lifetime of complications for the next generation.

Hemoglobinopathies that may have normal or near-normal hemoglobin:

The real goal:

Detect early.

Counsel early.

Prevent severe hemoglobinopathies.

Screening principles to follow:

Do not rely on hemoglobin alone.
Look for clues: low MCV/MCH, high RBC count, target cells, family/ethnic history.
Use HPLC/electrophoresis as a screening tool.
Screen both partners (premarital/antenatal).
Counsel and guide at-risk couples.
Consider molecular testing when needed (especially for α-thalassemia).
Universal and community screening can save generations.

Every HPLC report is more than numbers – it is an opportunity to change a family’s future.

Let’s keep raising awareness, strengthening screening, and working together to reduce the burden of hemoglobin disorders.”

Smitirupa Mishra