A 20-year-old Black man presented to primary care for preoperative evaluation for elective laparoscopic cholecystectomy due to gallstone disease. The patient had a blood test and was found to have mild anemia with microcytosis. Peripheral blood smear revealed target cells, microspherocytes, and Hb C crystals. Hb C is a variant of normal hemoglobin A (Hb A) that results from a missense mutation in the β-globin protein, substituting glutamic acid at position 6 with a lysine molecule. The disease can be in either a homozygous state (Hb CC) or a heterozygous state (Hb AC or Hb SC). The origin of this mutation dates back to West Africa and has been found to provide protection against severe manifestations of malaria. In the United States, the Hb C allele is prevalent in approximately 1-2% of the African American population. The prevalence of homozygous disease (e.g., Hb CC) is only 0.02%. Source: https://labmedicineblog.com/category/hematology
Hemoglobin C Crystals in Peripheral Blood Smear
Clinical case of hemoglobinopathy C: erythrocyte morphology, target cells, microspherocytes, and Hb C crystals in peripheral blood.
