Italian 
English Una anemia in gravidanza da indagare attentamente
A pregnant woman with anemia to be carefully investigated
AUTORI
UOC Medicina di Laboratorio, Azienda Ulss 2 "Marca Trevigiana", Treviso
ABSTRACT
A pregnant woman with anemia to be carefully investigated
A 29-year-old woman, of Italian origin (Treviso, Italy), during her second pregnancy, was examined at the out-patients section of the laboratory a few years ago, to investigate the anemic status. Among the clinical information available on that occasion, there was a diagnosis of hemolytic anemia due to a possible haemoglobinopathy, that had led to a splenectomy at the age of 24 years. The hemoglobin pattern performed using a HPLC instrument (Variant II, Bio-Rad, USA) did not show the presence of any hemoglobin variant, but a reduced value of HbA2 was observed. At that time, the anemia was not particularly marked considering the pregnancy (92 g/L (r.i. 120-160). Further investigations to check the presence of unstable variants and the characterization of the variants by mass spectrometry, together with the clinical history of the family, allowed to characterize an unstable variant of the alpha globin chains (Hb Torino) and to identify a condition of alpha thalassemia in trans. During her third pregnancy, the monitoring of the glycemic status showed particularly low values of glycated hemoglobin (HbA1c) due to the instability of the Hb variant present.