Abstract:Hemoglobin C Diseaseto the editor: Although the appearance of the blood smear presented by Fairhurst and Casella (June 24 issue) 1 is consistent with the presence of hemoglobin C disease, the extremel...Hemoglobin C Diseaseto the editor: Although the appearance of the blood smear presented by Fairhurst and Casella (June 24 issue) 1 is consistent with the presence of hemoglobin C disease, the extremely low mean corpuscular volume and the clinical scenario are more consistent with the presence of hemoglobin C b -thalassemia.Hemoglobin C b -thalassemia is common in African populations, and the clinical disorder is usually mild; features include low-grade anemia, a low mean corpuscular volume, and minimal elevation of the reticulocyte count, without splenomegaly.The blood smear is indistinguishable from that in hemoglobin C disease and shows microspherocytes and target cells. 2The electrophoretic pattern is dependent on whether the thalassemia is the b + or b 0 type.Hemoglobin electrophoresis will not differentiate hemoglobin C from hemoglobin C b -thalassemia because hemoglobins C and A 2 migrate together.Cation-exchange high-performance liquid chromatography is necessary to detect elevated hemoglobin A 2 levels. 2In addition, in the current case, the analysis of the mother's hemoglobin may help in the diagnosis.We suspect that she would test positive for thalassemia.Read More