Hemoglobin blood test low
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Understanding Low Hemoglobin Blood Test Results
Causes of Low Hemoglobin Levels
Anemia and Hemoglobin Variants
Low hemoglobin levels, commonly referred to as anemia, can be caused by various factors, including nutritional deficiencies, chronic diseases, and genetic conditions. One significant cause is the presence of variant hemoglobins, which can lead to unexpectedly low oxygen saturation (SpO2) measurements despite normal arterial oxygen saturation (SaO2) levels. This discrepancy is due to abnormal light absorption spectra of these variant hemoglobins, which can mislead pulse oximetry readings and result in unnecessary investigations 1.
Thalassemia and Hemoglobinopathies
Another genetic cause of low hemoglobin levels is thalassemia. For instance, a case study highlighted a Tujia Chinese woman with a rare type of β-thalassemia, which led to abnormally low glycosylated hemoglobin A1c (HbA1c) levels. This condition was identified through abnormal chromatograms during high-performance liquid chromatography (HPLC) testing, emphasizing the need for differential diagnosis in patients with unexplained low HbA1c levels 6.
Diagnostic Tools and Techniques
Traditional Blood Tests
Traditional methods for measuring hemoglobin concentration ([Hb]) involve blood draws and laboratory analysis. These methods are accurate but can be costly and time-consuming, especially in resource-limited settings. A novel paper-based assay has been developed to address this issue, providing a low-cost, accurate alternative for diagnosing anemia. This assay uses a simple mixture of blood and Drabkin reagent on chromatography paper, offering a feasible solution for low-income regions 2.
Non-Invasive Methods
Recent advancements have introduced non-invasive techniques for hemoglobin measurement. For example, a smartphone app has been developed to estimate hemoglobin levels by analyzing photos of fingernail beds. This app can detect anemia with high accuracy and sensitivity, making it a practical tool for on-demand, remote monitoring of hemoglobin levels 4. Another innovative approach involves using smartphone spectroscopy to measure hemoglobin levels based on the color of the conjunctival pallor, providing a reliable and autonomous method for anemia diagnosis 8.
Bedside Photometers
The HemoCue Plasma/Low Hemoglobin System is another tool validated for accurately measuring low levels of hemoglobin-based oxygen carriers (HBOCs) in plasma. This bedside photometer offers high reliability and can be used for rapid, on-site hemoglobin testing, which is particularly useful in critical care settings 3.
Clinical Implications and Recommendations
Differential Diagnosis
Clinicians must adopt a systematic approach to diagnose the cause of low hemoglobin levels accurately. This involves considering the patient's history, laboratory values, and potential genetic factors. An organized diagnostic algorithm can help clinicians navigate the extensive differential diagnosis of anemia, ensuring that no potential cause is overlooked 7.
Avoiding Unnecessary Investigations
Understanding the role of variant hemoglobins in causing low SpO2 readings can prevent unnecessary cardiopulmonary testing and reduce patient anxiety. Correctly identifying these variants through appropriate diagnostic tests can spare patients from invasive procedures and lead to more accurate diagnoses 1.
Conclusion
Low hemoglobin levels can result from various causes, including nutritional deficiencies, chronic diseases, and genetic conditions like thalassemia and hemoglobinopathies. Advances in diagnostic tools, including non-invasive methods and low-cost assays, are improving the accuracy and accessibility of anemia diagnosis. Clinicians must use a systematic approach to diagnose the underlying cause of low hemoglobin levels, considering both traditional and innovative diagnostic techniques to provide the best patient care.
Sources and full results
Most relevant research papers on this topic
Unexpectedly low pulse oximetry measurements associated with variant hemoglobins: A systematic review
Variant hemoglobins can cause unexpectedly low pulse oximetry measurements, potentially causing unnecessary investigations and anxiety in asymptomatic patients.
Systematic Review
Highly CitedSimple paper-based test for measuring blood hemoglobin concentration in resource-limited settings.
The paper-based hemoglobin assay is a feasible, low-cost test for diagnosing anemia in resource-limited settings, particularly in sub-Saharan Africa.
Highly CitedThe novel HemoCu plasma/low hemoglobin system accurately measures small concentrations of three different hemoglobin-based oxygen carriers in plasma: hemoglobin glutamer-200 (bovine) (Oxyglobin), hemoglobin glutamer-250 (bovine) (Hemopure), and hemoglobin-Raffimer (Hemolink).
The HemoCue Plasma/Low Hemoglobin System accurately measures small concentrations of three hemoglobin-based oxygen carriers in plasma, with high intraobserver and interobserver reliabilities.
Smartphone app for non-invasive detection of anemia using only patient-sourced photos
Our smartphone app accurately detects anemia using fingernail bed photos, enabling non-invasive blood-based diagnostics without external equipment.
Observational StudyHighly CitedSensor system for non-invasive optical hemoglobin determination
Non-invasive optical hemoglobin determination allows pain-free online patient monitoring with minimal risk of infection and real-time data monitoring, enabling immediate clinical reaction to measured data.
Case Report: Abnormally Low Glycosylated Hemoglobin A1c Caused by Clinically Silent Rare β-Thalassemia in a Tujia Chinese Woman
Clinically silent -thalassemia may cause low HbA1c values and abnormal chromatograms by HPLC, highlighting the need for differential diagnosis and further tests.
Case ReportDifferential Diagnosis of Low Hemoglobin
A systematic approach using patient history and laboratory values is crucial for accurately diagnosing low hemoglobin levels in patients.
sHEMO: Smartphone Spectroscopy for Blood Hemoglobin Level Monitoring in Smart Anemia-Care
Smartphone spectroscopy, using conjunctival pallor color spectroscopy, accurately detects blood hemoglobin levels, offering a reliable and affordable alternative to blood-based laboratory tests for at-home diagnosis of anemia.
Biocatalytically initiated precipitation ATRP as a quantitative method for hemoglobin detection in biological fluids.
The ATRP method accurately detects and quantifies hemoglobin in biological fluids, offering an environmentally friendly alternative to toxic chemical assays.
Paper-based microchip electrophoresis for point-of-care hemoglobin testing.
HemeChip is a paper-based microchip electrophoresis platform that accurately identifies common hemoglobin variants in low-resource settings, addressing a major need for decentralized hemoglobin analysis in resource-limited settings.
Observational Study