This case report concerns a 71 year old female patient who had a very low glycosylated hemoglobin (HbA1c) despite having a high level of fasting blood glucose. The patient had a decreased erythrocyte count, elevated red blood cell indices, and a reticulocyte count with no evidence of hemoglobinopathy. She reported receiving hydroxychloroquine treatment for systemic lupus erythematosus. Subsequent laboratory investigations revealed hemolysis with formation of cold agglutinin. Because cold agglutinins can interfere with HbA1c assays, the specimens were reanalyzed after warming. The complete blood count results improved, but the HbA1c result did not change. In patients in whom medications and/or medical conditions may interfere with HbA1c levels, alternative measures of glycemic control, such as fructosamine, could be beneficial.
Keyphrases
- blood glucose
- glycemic control
- red blood cell
- case report
- systemic lupus erythematosus
- type diabetes
- peripheral blood
- end stage renal disease
- blood pressure
- ejection fraction
- newly diagnosed
- healthcare
- weight loss
- prognostic factors
- high throughput
- peritoneal dialysis
- patient reported outcomes
- single cell
- adipose tissue
- rheumatoid arthritis
- metabolic syndrome
- fine needle aspiration