A CBC shows HbC predominance on electrophoresis with rectangular crystals on smear. What is the presumptive diagnosis?

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Multiple Choice

A CBC shows HbC predominance on electrophoresis with rectangular crystals on smear. What is the presumptive diagnosis?

The main idea is that HbC crystals in red cells are highly characteristic of hemoglobin C. When electrophoresis shows HbC as the predominant hemoglobin, it points to homozygous hemoglobin C disease rather than other conditions. In HbC disease, most of the hemoglobin is HbC with little or no HbA present, whereas in HbC trait you’d expect a mix of HbA and HbC rather than HbC dominance. Sickle cell disease or trait would show hemoglobin S on electrophoresis, not HbC, and iron deficiency anemia does not produce HbC crystals or HbC dominance. So the pattern described—the HbC predominance on electrophoresis plus rectangular HbC crystals on smear—fits hemoglobin C disease.

The main idea is that HbC crystals in red cells are highly characteristic of hemoglobin C. When electrophoresis shows HbC as the predominant hemoglobin, it points to homozygous hemoglobin C disease rather than other conditions. In HbC disease, most of the hemoglobin is HbC with little or no HbA present, whereas in HbC trait you’d expect a mix of HbA and HbC rather than HbC dominance. Sickle cell disease or trait would show hemoglobin S on electrophoresis, not HbC, and iron deficiency anemia does not produce HbC crystals or HbC dominance. So the pattern described—the HbC predominance on electrophoresis plus rectangular HbC crystals on smear—fits hemoglobin C disease.

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