Abstract
A 52-year-old man presented for an evaluation of worsening glycemic control secondary to glucocorticoid administration. The glycated hemoglobin (HbA1c) level was 8%, and oral glucose tolerance testing revealed impaired tolerance, whereas the plasma glucose and glycoalbumin levels were normal. The results of high-performance liquid chromatography (HPLC) for HbA1c, isoelectrofocusing of the hemolysate and precise HPLC measurements of the HbA1c level supported the presence of an Hb variant, and DNA sequencing of the β-globin gene revealed Hb Yahata [β112 TGT (Cys)→TAT (Tyr)] (heterozygote). In this case, the discrepancy between the plasma glucose and HbA1c levels raised suspicion of this rare Hb variant.
Publication types
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Case Reports
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Research Support, Non-U.S. Gov't
MeSH terms
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Blood Glucose / genetics
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Blood Glucose / metabolism*
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Chromatography, High Pressure Liquid*
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Glucocorticoids / administration & dosage*
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Glucocorticoids / adverse effects
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Glucose Tolerance Test
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Glycated Hemoglobin / genetics
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Glycated Hemoglobin / metabolism*
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Glycated Serum Albumin
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Glycation End Products, Advanced
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Hemoglobins, Abnormal / genetics
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Hemoglobins, Abnormal / isolation & purification*
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Humans
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Male
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Middle Aged
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Neuromyelitis Optica / blood
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Neuromyelitis Optica / drug therapy*
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Sequence Analysis, DNA
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Serum Albumin
Substances
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Blood Glucose
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Glucocorticoids
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Glycated Hemoglobin A
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Glycation End Products, Advanced
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Hemoglobins, Abnormal
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Serum Albumin
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hemoglobin A1c protein, human
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hemoglobin Yahata
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Glycated Serum Albumin