CASE STUDY 19.3

A32-year-old African American woman came to the obstetrics and gynecology clinic of her local hospital because she was feeling a little weak. A CBC showed hemoglobin of 9.9 g/dL (reference range 11.7 to 15.7 g/dL), with an MCV of 87 fL (reference range 80 to 100 fL). The physician ordered a hemoglobin electrophoresis as a follow-up. The cellulose acetate pattern showed a peak of 58% at the hemoglobin A position, a peak of 35% at the hemoglobin S position, and a peak of 5% at the A2 position. Further studies indicated a positive dithionite solubility test result and a hemoglobin F value of 1%.

Questions

1. What is the best possible diagnosis for this woman?
2. Does this condition require further follow-up and treatment?
3. What implications does this disease have for her unborn child?
4. Are the values for hemoglobins A2 and F normal for this condition?