Test Definition: HBELC Hemoglobin Electrophoresis Cascade, Blood
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1 Reporting Title: HGB Electrophoresis Cascade Performing Location: Rochester Advisory Information: Alpha-thalassemias with only 1 or 2 alpha-globin gene deletions are not recognized by this testing protocol. ATHAL / Alpha-Globin Gene Analysis is required to identify 1 or 2 globin gene deletions. Necessary Information: Include recent transfusion information. Specimen Requirements: Container/Tube: Preferred: Lavender top (EDTA) Acceptable: ACD (solution B), green top (sodium heparin) Specimen Volume: 10 ml Collection Instructions: Send specimen in original tube. Do not aliquot. Forms: 1. New York Clients-Informed consent is required. Please document on the request form or electronic order that a copy is on file. An Informed Consent for Genetic Testing (T576) is available in Special Instructions. 2. Thalassemia/Hemoglobinopathy Patient Information (T358) in Special Instructions 3. If not ordering electronically, complete, print, and send 1 of the following forms with the specimen: General Request Form (T239) ( Benign Hematology Test Request Form (T755) ( Whole Blood EDTA Refrigerated 7 days Ask at Order Entry (AOE) Questions: Test ID Question ID Description Type Reportable CULAF CG767 Reason for Referral Plain Text No Document generated February 6, 2018 at 12:32pm CST Page 1 of 5
2 Result Codes: Result ID Reporting Name Type Unit LOINC 2381 Hemoglobin A2 Numeric % Also used by tests: A2F 2382 Hemoglobin F Numeric % Also used by tests: A2F 2380 Hemoglobin A Numeric % Variant Alphanumeric % Variant 2 Alphanumeric % Variant 3 Alphanumeric % Interpretation Alphanumeric LOINC and CPT codes are provided by the performing laboratory. Supplemental Report: No Components: A2F Hemoglobin A2 and F Yes No HBEL Hemoglobin Electrophoresis, B Yes No Reflex Tests: SDEX Hemoglobin S, Scrn, B No Yes IEF IEF Confirms No No MASS Hb Variant by Mass Spec, B No No UNHB Unstable Hemoglobin, B No No ATHAL Alpha-Globin Gene Analysis No Yes Document generated February 6, 2018 at 12:32pm CST Page 2 of 5
3 CULAF Amniotic Fluid Culture/Genetic Test Profile No Yes MATCC Maternal Cell Contamination, B No Yes CULFB Fibroblast Culture for Genetic Test Profile No Yes _STR1 Comp Analysis using STR (Bill only) No No _STR2 Add'l comp analysis w/str (Bill Only) No No WASQR Alpha Globin Gene Sequencing, B No Yes (Order WASEQ) WBSQR Beta Globin Gene Sequencing, B No Yes (Order WBSEQ) WBDDR Beta Globin Cluster Locus Del/Dup,B No Yes (Order WBDD) WGSQR Gamma Globin Full Gene Sequencing No Yes (Order WGSEQ) HBELA HGB Electrophoresis Summary Interp No No HPFH Hemoglobin F, Red Cell Distrib, B No No Result Codes for Reflex Tests: Test ID Result ID Reporting Name Type Unit LOINC SDEX 9180 Hemoglobin S, Scrn, B Alphanumeric IEF IEF Confirms Alphanumeric MASS Hb Variant by Mass Spec, B Alphanumeric In Process UNHB 9095 Hemoglobin, Unstable, B Alphanumeric ATHAL Result Summary Alphanumeric ATHAL Result Alphanumeric ATHAL Interpretation Alphanumeric ATHAL Additional Information Alphanumeric ATHAL Specimen Alphanumeric ATHAL Source Alphanumeric ATHAL Method Alphanumeric ATHAL Released By Alphanumeric In Process Document generated February 6, 2018 at 12:32pm CST Page 3 of 5
4 Test ID Result ID Reporting Name Type Unit LOINC CULAF Result Summary Alphanumeric CULAF Interpretation Alphanumeric CULAF Result Alphanumeric In Process CULAF CG767 Reason for Referral Alphanumeric CULAF Specimen Alphanumeric CULAF Source Alphanumeric CULAF Method Alphanumeric CULAF Additional Information Alphanumeric CULAF Released By Alphanumeric In Process MATCC Result Summary Alphanumeric MATCC Result Alphanumeric MATCC Interpretation Alphanumeric MATCC Reason for Referral Alphanumeric MATCC Specimen Alphanumeric MATCC Source Alphanumeric MATCC Method Alphanumeric MATCC Released By Alphanumeric No LOINC Needed WASQR Alpha Globin Gene Sequencing Result Alphanumeric In Process WASQR Interpretation Alphanumeric In Process WBSQR Beta Globin Gene Sequencing Result Alphanumeric In Process WBSQR Interpretation Alphanumeric In Process WBDDR Beta Globin Cluster Locus Del/Dup Alphanumeric In Process WBDDR Reviewed by Alphanumeric In Process WBDDR Interpretation Alphanumeric In Process WGSQR Gamma Globin Gene Sequencing Result Alphanumeric In Process WGSQR Gamma Globin Interpretation Alphanumeric In Process HBELA HGB Electrophoresis Summary Interp Alphanumeric In Process HBELA Reviewed by Alphanumeric In Process HPFH 8270 Hemoglobin F, Red Cell Distrib, B Alphanumeric HPFH 2104 Interpretation Alphanumeric Document generated February 6, 2018 at 12:32pm CST Page 4 of 5
5 Reference Values: HEMOGLOBIN A 1-30 days: % 1-2 months: % 3-5 months: % 6-8 months: % 9-12 months: % months: % months: % > or =24 months: % HEMOGLOBIN A days: % 1-2 months: % 3-5 months: % > or =6 months: % HEMOGLOBIN F 1-30 days: % 1-2 months: % 3-5 months: % 6-8 months: % 9-12 months: % months: % months: % > or =24 months: % VARIANT VARIANT 2 VARIANT 3 Document generated February 6, 2018 at 12:32pm CST Page 5 of 5
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