A patient has two bands on alkaline hemoglobin electrophoresis. One lines up with Hb A and the other is in the S position. Select the best course of action
a. Report as normal
b. Report as sickle trait
c. Report as sickle disease
d. Confirm sickle gene with tube solubility test
ANS: D
Other abnormal hemoglobins migrate with Hb S on alkaline hemoglobin electrophoresis; Hb D is an example. However, these hemoglobins are not sickling hemoglobins. Therefore a positive tube solubility test would confirm that the hemoglobin in the S position is Hb S.
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