Unmeasurable Hemoglobin A1c due to Extreme Hyperglycemia in High-performance Liquid Chromatography Method: A Case Report

• DOI: 10.3889/oamjms.2023.11728
• Publication Date: 2024-01-11T14:29:55Z
• Authors: Hiroki Doi; Midori Saito; Ayane Ozaki; Yuya Ishihara; Takashi Fujita; Hidehiko Akiyama; Hiroyasu Ito
• Keywords: Glycated hemoglobin

BACKGROUND: Hemoglobin A1c (HbA1c), which is one of the important parameters considered when judging degree glucose concentrations during preceding 8–12 weeks, used as standard assessment glycemic control in patients with diabetes. However, some measurement principles may cause errors HbA1c measurement. CASE REPORT: A 49-year-old male patient hyperglycemic hyperosmotic syndrome had an extreme high blood level 2,161 mg/dL and that was not measurable due to a large amount labile HbA1c. Many institutions measure by high-performance liquid chromatography (HPLC). We using ARKRAY HA-8190V (ion-exchange HPLC) report National Glycohemoglobin Standardization Program (NGSP) (%). this case, so we requested glycated albumin substitute revealed abnormal value 64.5%. HPLC analysis #C peak, appeared be HbA1c, before peak. The treated insulin therapy, 14.1% day after controlled. CONCLUSION: emphasiz measurements situations hyperglycemia.