low Hb A2..

Hi Andy,

My kid Ruhan was diagnosed with thal major when he was 4 months old. One striking feature of his blood report was low Hb A2 = 1.7. Does this indicate any different or less severe mutation, can thal major have low Hb A2?

He is now 10 months old and has twice undergone blood transfusions, he seems to maintain a healthy gap of 2-3 months between 2 transfusions. We have put him on wheatgrass too, is that the reason?

regards,
Mudit

Hi Mudit,

HbA2 is the hemoglobin that is created by the combination of alpha globin from the alpha gene and delta globin from the delta gene. When there is some defect or mutation in the delta gene, this type of hemoglobin is produced at lower amounts, if at all, as with delta zero. The relevance in terms of thalassemia is that the low HbA2 can mask the thalassemia in the hemoglobin electrophoresis test because when looking at the results of the electrophoresis, it is expected that a higher level of HbA2 will be observed, and when a low level is measured, it is assumed that the patient is not thal. In your son's case, the thalassemia was diagnosed in proper time so it is of no real relevance. It will not cause any noticeable difference. His transfusion gap is as expected for his age and will shrink as he gets older. Wheatgrass may have some effect on transfusion frequency and is highly recommended.