FRCPath Haematology Part 2: Morphology Thalassaemias and Haemoglobinopathies Common Variant Haemoglobins

The table below summarises normal and common haemoglobin variants, as well as their typical mobilities on alkaline and acid electrophoresis and HPLC. The two main haemoglobins with a positive sickle solubility test are haemoglobin S and C-Harlem. The sickle solubility test can hence be used as an adjunct when variants with the mobility / retention time of haemoglobin S is detected.

HaemoglobinGlobin ChainUsual %AlkalineAcidHPLCSickle Test
Aα2ß296 – 98AAANegative
A2α2δ22 – 3.5CAA2Negative
Bart’sα-/-α-/-N/AFastFP1Negative
CßC40 – 45CCCNegative
C-HarlemßC-Harlem40 – 45CSCPositive
Constant SpringαCS2 – 3SlowACNegative
DßD40 – 45SADNegative
EßE30 – 35CAA2Negative
Fα2Γ2< 1FFFNegative
GαG-Phil35 – 45SADNegative
Hα+/-α-/-N/AFastAP1Negative
Leporeδß fusion7 – 15SAA2Negative
O-ArabßO-Arab40 – 45CSCNegative
Q-ThailandαQ-Thailand25 – 35SA-SSNegative
SßS40 – 45SSSPositive
Normal and variant haemoglobins and their characteristics on HPLC and gel electrophoresis. Usual percentages are reflected for patient’s with one variant haemoglobin and one normal haemoglobin. For the ß globin variants, usual percentages are approximately 5% lower for each co-inherited α thalassaemia gene.
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