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Tareq Abadl: Hemoglobin Electrophoresis Patterns Across Thalassemia Syndromes
Sep 27, 2026, 09:03

Tareq Abadl: Hemoglobin Electrophoresis Patterns Across Thalassemia Syndromes

Tareq Abadl, Medical Lab Specialist, shared a post on LinkedIn:

“Thalassemia – Hemoglobin Analysis.

Know the Pattern, Know the Diagnosis.

  • β-Thalassemia Trait
  • HbA: Predominant
  • HbA₂: high Increased
  • HbF: Normal or mildly high

Key clue:

Microcytosis plus high HbA₂ – Think β-thalassemia trait.

β-Thalassemia Major

  • HbA: Absent or markedly low
  • HbF: Predominant high
  • HbA₂: Variable

Severe reduction/absence of β-globin production – marked increase in HbF.

α-Thalassemia Trait

In adults:

  • HbA: Predominant
  • HbA₂: Normal or slightly low
  • HbF: Normal

Important: Hemoglobin electrophoresis may be normal in α-thalassemia trait.

HbH Disease

  • HbH (β₄): May be detected
  • HbA: Predominant
  • HbA₂: low
  • HbF: Usually normal or slightly high

Peripheral smear may show HbH inclusions with supravital staining.

ASCP Pearl

High HbA₂ is a classic laboratory clue for β-thalassemia trait.

But remember: Normal electrophoresis ≠ No thalassemia – α-thalassemia trait can have a normal adult hemoglobin pattern.

Quick Memory

  • β-thal trait – HbA₂ high
  • β-thal major – HbF high
  • α-thal trait – Electrophoresis often normal
  • HbH disease – HbH (β₄).”

Tareq Abadl: Hemoglobin Electrophoresis Patterns Across Thalassemia Syndromes

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