Hemoglobin F, Blood
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Fetal hemoglobin concentration is usually between 5% to 15% of the total hemoglobin in the high F or delta/beta-type of thalassemia minor. In beta-thalassemia major, fetal hemoglobin may be 30% to 90% or even more of the total hemoglobin.
Slight increases in hemoglobin F concentration are found in a variety of unrelated hematologic disorders, such as aplastic anemia, hereditary spherocytosis, and myeloproliferative disorders. In homozygous sickle cell disease, hemoglobin F concentration is often slightly increased.
Higher concentrations of hemoglobin F occur in hemoglobin S/beta O-thalassemia, in patients who are doubly heterozygous for the hemoglobin S gene, and in patients who have a gene for hereditary persistence of fetal hemoglobin (HPFH). These disorders may be differentiated by family studies or by flow cytometry studies for fetal hemoglobin, which reveals uniform intraerythrocytic distribution of hemoglobin F in HPFH and nonuniform distribution in hemoglobin S/beta-thalassemia. The electrophoretic finding of small quantities of hemoglobin A in a patient who has mostly hemoglobin S and a moderate increase in hemoglobin F is strong evidence of hemoglobin S/beta zero thalassemia (if the patient has not had a transfusion).
Quantitating the percent of fetal hemoglobin present
Assisting in the diagnosis of disorders with elevated levels of fetal hemoglobin
See Clinical Information and Reference Values.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Hemoglobin F is elevated in newborns, reaching adult levels by 12 months. It is also commonly increased to as much as 5% to 10% in normal pregnancy.
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
1-30 days: 22.8-92.0%
1-2 months: 7.6-89.8%
3-5 months: 1.6-42.2%
6-8 months: 0.0-16.7%
9-12 months: 0.0-10.5%
13-17 months: 0.0-7.9%
18-23 months: 0.0-6.3%
> or =24 months: 0.0-0.9%
Clinical References Provides recommendations for further in-depth reading of a clinical nature
Fairbanks VF, Klee GG: Biochemical aspects of hematology. In Tietz Textbook of Clinical Chemistry. Third edition. Edited by CA Burtis, ER Ashwood, Philadelphia, WB Saunders Company, 1999, pp 1657-1669