---
title: "Hb G‑Philadelphia and alpha‑thalassemia detected incidentally during HbA1c HPLC testing"
id: "pubmed-42470431"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42470431"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42470431/"
doi: "10.1684/abc.2026.2049"
published_at: "2026-08-27T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Hb G‑Philadelphia and alpha‑thalassemia detected incidentally during HbA1c HPLC testing
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42470431
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42470431/)
- **DOI:** [10.1684/abc.2026.2049](https://doi.org/10.1684%2Fabc.2026.2049)
- **Published At:** 2026-08-27T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- A 28‑year‑old woman from southeastern Morocco with refractory **hypochromic microcytic anemia** (Hb 10.6 g/dL, MCV 60.5 fL, MCH 20.3 pg) underwent testing because of a family history of type 2 diabetes. - Routine **HbA1c** measurement by Bio‑Rad D‑100 HPLC showed an unexpected hemoglobin peak eluting in the D window (87.44%), prompting further workup. - Additional laboratory methods used to investigate the variant included **HPLC Variant II**, capillary electrophoresis, and acid pH gel electrophoresis; these confirmed the presence of **homozygous Hb G‑Philadelphia**. - Molecular analysis corroborated the Hb variant and identified its association with mild **alpha‑thalassemia** due to the -α3.7 deletion. - Family study found the patient’s daughter to be a **heterozygous carrier of Hb G‑Philadelphia** and to carry a cis -α3.7 **α‑thalassemia trait**. - The report highlights that **Hb G‑Philadelphia** results from an α‑globin substitution [α68(E17) Asn→Lys], is usually clinically silent, and can be challenging to identify, particularly when homozygous and co‑inherited with deletional **α‑thalassemia**. - Keywords and diagnostic flags in the case included **HPLC**, electrophoresis, hemoglobinopathy, thalassemic alpha trait, glycated hemoglobin analysis, and incidental finding during routine testing. - Specifics of clinical management, longitudinal follow‑up, and full molecular details beyond the -α3.7 association were not reported in the source abstract.
## Clinical Analysis & Structured Key Points
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Affiliations Expand ### Affiliations * 1 Laboratoire de Recherche et d'Analyses Médicales de la Gendarmerie Royale, Laboratoire d'Hématologie de l'Hôpital Militaire d'Instruction Mohammed V, Faculté de Médecine et de Pharmacie, Université Mohammed V, Rabat. * 2 Laboratoire Central d'Hématologie Ibn Sina-Rabat, Faculté de Médecine et de Pharmacie, Université Mohammed V, Rabat, Maroc. * 3 Laboratoire d'Hématologie de l'Hôpital Militaire d'Instruction Mohammed V, Faculté de Médecine et de Pharmacie, Université Mohammed V, Rabat, Maroc. * 4 Pôle des laboratoires de l'Hôpital Militaire d'Instruction Mohammed V, Faculté de Médecine et de Pharmacie, Université Mohammed V, Rabat, Maroc. * PMID: **42470431** * DOI: [ 10.1684/abc.2026.2049 ](https://doi.org/10.1684/abc.2026.2049) Item in Clipboard Case Reports # [Alpha-thalassemia with Hb G-Philadelphia incidentally discovered during HbA1c testing] [Article in French] Sophia Kahouli et al. Ann Biol Clin (Paris). 2026. Show details Display options Display options Format Abstract PubMed PMID Ann Biol Clin (Paris) Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Ann+Biol+Clin+%28Paris%29%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Ann+Biol+Clin+%28Paris%29%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42470431/) . 2026 Aug 27;84(3):300-306. doi: 10.1684/abc.2026.2049. ### Authors [Sophia Kahouli](https://pubmed.ncbi.nlm.nih.gov/?term=Kahouli+S&cauthor_id=42470431)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42470431/#short-view-affiliation-1 "Laboratoire de Recherche et d'Analyses Médicales de la Gendarmerie Royale, Laboratoire d'Hématologie de l'Hôpital Militaire d'Instruction Mohammed V, Faculté de Médecine et de Pharmacie, Université Mohammed V, Rabat."), [Azlarab Masrar](https://pubmed.ncbi.nlm.nih.gov/?term=Masrar+A&cauthor_id=42470431)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42470431/#short-view-affiliation-2 "Laboratoire Central d'Hématologie Ibn Sina-Rabat, Faculté de Médecine et de Pharmacie, Université Mohammed V, Rabat, Maroc."), [Souad Benkirane](https://pubmed.ncbi.nlm.nih.gov/?term=Benkirane+S&cauthor_id=42470431)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42470431/#short-view-affiliation-2 "Laboratoire Central d'Hématologie Ibn Sina-Rabat, Faculté de Médecine et de Pharmacie, Université Mohammed V, Rabat, Maroc."), [Hafid Zahid](https://pubmed.ncbi.nlm.nih.gov/?term=Zahid+H&cauthor_id=42470431)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42470431/#short-view-affiliation-3 "Laboratoire d'Hématologie de l'Hôpital Militaire d'Instruction Mohammed V, Faculté de Médecine et de Pharmacie, Université Mohammed V, Rabat, Maroc."), [Zahra Ouzzif](https://pubmed.ncbi.nlm.nih.gov/?term=Ouzzif+Z&cauthor_id=42470431)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42470431/#short-view-affiliation-4 "Pôle des laboratoires de l'Hôpital Militaire d'Instruction Mohammed V, Faculté de Médecine et de Pharmacie, Université Mohammed V, Rabat, Maroc.") ### Affiliations * 1 Laboratoire de Recherche et d'Analyses Médicales de la Gendarmerie Royale, Laboratoire d'Hématologie de l'Hôpital Militaire d'Instruction Mohammed V, Faculté de Médecine et de Pharmacie, Université Mohammed V, Rabat. * 2 Laboratoire Central d'Hématologie Ibn Sina-Rabat, Faculté de Médecine et de Pharmacie, Université Mohammed V, Rabat, Maroc. * 3 Laboratoire d'Hématologie de l'Hôpital Militaire d'Instruction Mohammed V, Faculté de Médecine et de Pharmacie, Université Mohammed V, Rabat, Maroc. * 4 Pôle des laboratoires de l'Hôpital Militaire d'Instruction Mohammed V, Faculté de Médecine et de Pharmacie, Université Mohammed V, Rabat, Maroc. * PMID: **42470431** * DOI: [ 10.1684/abc.2026.2049 ](https://doi.org/10.1684/abc.2026.2049) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID ## Abstract Hemoglobin G-Philadelphia is an alpha-globin chain variant resulting from the substitution of asparagine by lysine at position 68 [α68(E17) Asn→Lys]. This hemoglobin (Hb) variant is generally clinically silent; however, its identification may be challenging, particularly when present in the homozygous state and co-inherited with the -α3.7 deletion. We report the case of a 28-year-old woman from southeastern Morocco presenting with refractory hypochromic microcytic anemia (Hb 10,6 g/dL, MCV 60.5 fL, MCH 20.3 pg). Owing to a family history of type 2 diabetes mellitus, HbA1c testing was performed and revealed a hemoglobin variant eluting in the D window (87.44 %) on the Bio-Rad D-100 HPLC system. Further laboratory investigations (HPLC Variant II, capillary electrophoresis, and acid pH gel electrophoresis) confirmed the presence of homozygous Hb G-Philadelphia. Molecular analysis confirmed the variant and demonstrated its association with mild α-thalassemia. Family study revealed that the daughter is a heterozygous carrier of Hb G-Philadelphia and a cis -α3.7 α-thalassemia trait. **Keywords:** HPLC; HbA1c; electrophoresis; hemoglobin G Philadelphia; hemoglobinopathy; thalassemic alpha trait. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Similar articles * [ Analysis of rare thalassemia caused by HS-40 regulatory site deletion. ](https://pubmed.ncbi.nlm.nih.gov/32720864/) Luo S, Chen X, Zhong Q, Wang Q, Xu Z, Qin L, Wang J, Yuan D, Yan T, Tang N.Luo S, et al.Hematology. 2020 Dec;25(1):286-291. doi: 10.1080/16078454.2020.1799587.Hematology. 2020.PMID: 32720864 * [ Hemoglobin profile and molecular characteristics of the complex interaction of hemoglobin Doi-Saket [α9(A7) asn > lys, HBA2:c.30C > a], a novel α2α1 hybrid globin variant, with hemoglobin E [β26(B8) Glu > lys, HBB:c.79G > A] and deletional α+-thalassemia in a Thai family. ](https://pubmed.ncbi.nlm.nih.gov/37796611/) Panyasai S, Khongthai K, Satthakarn S.Panyasai S, et al.Ann Med. 2023;55(2):2264174. doi: 10.1080/07853890.2023.2264174. 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Epub 2015 Dec 4.Hemoglobin. 2016.PMID: 26635043Review. * [ Characterization and Confirmation of Mildly Unstable Hb Pontoise or α1 63(E12) Ala > Asp and Literature Review. ](https://pubmed.ncbi.nlm.nih.gov/39833127/) Tang B, Chen K, Liang L, Li J, Wang J, He T, Guo H.Tang B, et al.Hemoglobin. 2025 Jan;49(1):26-30. doi: 10.1080/03630269.2025.2451411. Epub 2025 Jan 20.Hemoglobin. 2025.PMID: 39833127Review. 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