/ afp 71/No. Once the antigenic epitope is no longer produced, the hemolysis process ceases over a period of four weeks to four months (equivalent to one red-cell life span).6. Am Fam Physician 2004;69:2599-606. The A1C test result reflects your average blood sugar level for the past two to three months. Every person has a distinct blood type (A, B, AB, or O). Please enable it to take advantage of the complete set of features! However, there are different conditions that lead to a shortened lifespan of erythrocytes, resulting in falsely low HbA1C value. NIH HHS / Vol. Overview Hemoglobin a1C Normal Value Range Pathophysiology Special considerations Elevated values Decreased values Nursing Points General Normal value 5.6-7.5% Pathophysiology After a prolonged exposure to glucose molecules, HGB binds to glucose RBC life is 90-120 days Blood test measures average amount of HGB bound to glucose Measured as a percentage Goals – <5% for non-diabetics […] Assessment of glycemia in diabetes mellitus: hemoglobin A1c. The editors may edit letters to meet style and space requirements. This content is owned by the AAFP. With decreased erythropoiesis such as with iron deficiency anemia increased mean age of red blood cells increases hemoglobin A-1 C levels. Letters should be fewer than 400 words and limited to six references, one table or figure, and three authors. Abnormally low-HbA1c reading can be expected under conditions such as rapid loss of glycemic control [332,333], conditions that decrease erythrocyte lifespan such as hemolytic anemia [325], liver cirrhosis [334,335], hemorrhage, chronic kidney disease [336–339], variant hemoglobin [320,322,340], and hemoglobin in neonates [341,342]. Don't miss a single issue. Immeasurable glycosylated haemoglobin: a marker for severe haemolysis. doi: 10.1136/bcr-2013-200307. The interpretation of the A1c test assumes the red blood cells live an average of 120 days. Hemolytic anemia, blood loss, pregnancy, and some medications reduce the average red blood cell (RBC) lifespan, leading to reduced HbA1c concentrations . Hemolytic anemia leads to the reduced lifespan of red blood cells (RBC), and IDA prolongs it; as a result, there occurs the discrepancy in hemoglobin A1c (HbA1c) . Dhaliwal G, Cornett PA, Tierney LM Jr. Hemolytic anemia. Factors that affect interpretation of HbA1c Results: Any condition that shortens … NLM Submission of a letter will be construed as granting the AAFP permission to publish the letter in any of its publications in any form. All rights Reserved. The A1C test measures the amount of glycated hemoglobin in the blood, which reflects average blood glucose levels over the preceding 3 months. BMJ Case Rep. 2013 Aug 8;2013:bcr2013200307. Get Permissions, Access the latest issue of American Family Physician. 5. Incidence of a positive direct coombs test in patients on alpha-methyldopa. Inherited hemolytic anemia means that parents pass the gene for the condition on to their children. Pruss A, Salama A, Ahrens N, Hansen A, Kiesewetter H, Koscielny J, Dorner T. Immune hemolysis–serological and clinical aspects. De Sanctis V, Soliman AT, Elsedfy H, Yaarubi SA, Skordis N, Khater D, El Kholy M, Stoeva I, Fiscina B, Angastiniotis M, Daar S, Kattamis C. Mediterr J Hematol Infect Dis. Interestingly, the "satisfactory" glycemic control index in our patient warned of a shortened red-cell life span, rather than providing a reassuring sign to her physician. Clipboard, Search History, and several other advanced features are temporarily unavailable. Dhaliwal G, Cornett PA, Tierney LM Jr. Hemolytic anemia. Nonetheless, a dramatic improvement trend of glycemic control over the preceding year was reflected by her recent A1C values. • The apparently healthy patient was subsequently diagnosed with hemolytic anemia, which led to a rapid turnover of red blood cells (RBCs). If you have an unusual kind of hemoglobin (called a hemoglobin variation), your A1C test outcome might be wrongly high or wrongly reduced. LoBuglio AF, Jandl JH. Murad F. Immunohemolytic anemia during therapy with methyldopa. Contact Clin Exp Med 2003;3:55-64. 2009 Jun;30(6):525-7. doi: 10.1016/j.revmed.2008.10.010. Hemolytic Anemia Manifesting as Improved A1C Values. 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