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It depends on the variability of her haemolysis. If this is a steady state condition, HbA1c could be used for on-going monitoring - BUT it would be necessary to do some extra testing in the early phases to establish what her personal reference range should be. ************************************************************************************** Prof. Tim Reynolds Consultant Chemical Pathologist / Clinical Director - Diagnostics / R&D Lead, Burton Hospitals NHS Foundation Trust work tel: 01283 511511 ext 4035 work fax: 01283 593064 work email: [log in to unmask] work URL: www.burtonhospitals.nhs.uk This e-mail, and any files transmitted with it, are confidential and intended solely for the use of the individual to whom it is addressed. If you are not the intended recipient please destroy this message, delete any copies held on your systems, and notify the sender immediately. You should not retain copy or use this e-mail for any purpose, nor disclose all or any part of its content to any other person. If you have received this e-mail in error, please notify me on 01283 511511 Ext 4035 [Picture of tree not available] Please consider the environment before printing this e-mail ________________________________ From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of [log in to unmask] Sent: 07 August 2013 1:27 AM To: [log in to unmask] Subject: HbA1c and pyruvate kinase deficiency Hello all, I would greatly appreciate this group's opinion on the possibility to use HbA1c in a 14 year old girl with type 1 diabetes and pyruvate kinase deficiency. Usual guidelines say that in all hemolytic conditions HbA1c could be falsely underestimated due to to short RBC lifespan. However there are various articles (see below) that say that in PK deficiency it is mostly reticulocytes that are sequestered in the spleen and that older RBC's have a near normal lifespan: Selective reticulocyte destruction in erythrocyte pyruvate kinase deficiency William C. Mentzer Jr., Robert L. Baehner, Holger Schmidt-Schönbein, Stephen H. Robinson, David G. Nathan Published in Volume 50, Issue 3 J Clin Invest. 1971; 50(3):688-699 doi:10.1172/JCI106539 Red cell pyruvate kinase deficiency: molecular and clinical aspects Alberto Zanella,1 Elisa Fermo,1 Paola Bianchi,1 and Giovanna Valentini2,3 2005 Blackwell Publishing Ltd, British Journal of Haematology, 130, 11-25 Could this mean that HbA1c can be used, with caution, in this condition? Any experiences? Antonio Croce Sondrio Hospital Laboratory, Italy [log in to unmask] <mailto:[log in to unmask]> ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/ ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/