Detection of haemoglobin J in an asymptomatic diabetic patient-a case report

India is an ethnically diverse country with marked regional variation. This diversity is reflected in the presence of different Hb variants in different ethnic groups. Hb J Meerut is one such rare variant detected by HPLC as abnormal peak (25.4%) in P3 window with a retention time of 1.85 minutes. This clinically asymptomatic variant has been reported to interfere with HBA1C estimation in diabetic patients. HBA1C values are routinely done to assess glycaemic control in diabetic patients. HbA1C values may be falsely low due to presence of abnormal HB variants. As HbA1C is based on haemoglobin, both quantitative and qualitative, variants in haemoglobin can affect HBA1C values. Here we report a case of a 45 year old male diabetic patient who had a spuriously low HBA1C value on HPLC with an abnormal peak in P3 window. Hb electrophoresis done to detect variant haemoglobin showed an abnormal peak (25.4%) in P3 window at a retention time of 1.85 minutes. A provisional diagnosis of HBJ Meerut was made which was confirmed by capillary electrophoresis.