Differential Diagnosis: Hemoglobin FC pattern on newborn screen is highly suggestive of homozygous hemoglobin C, hemoglobin C/beta zero thalassemia or hemoglobin C/hereditary persistence of fetal hemoglobin (Hb C/HPFH).
Condition Description: A red blood cell disorder characterized by presence of fetal hemoglobin (F) and hemoglobin C in the absence of hemoglobin A. The hemoglobins are listed in order of the amount of hemoglobin present (F>C).
YOU SHOULD TAKE THE FOLLOWING ACTIONS:
CBC and MCV. Hemoglobin separation by electrophoresis, isoelectric focusing, or high performance liquid chromatography (HPLC), shows FC pattern. DNA studies may be used to confirm genotype.
Infant is usually normal at birth. Hemoglobin CC is associated with a mild hemolytic anemia. Aplastic crises and gallstones may occur. Individuals with hemoglobin C/beta zero have a moderately severe anemia, splenomegaly, and may have bone changes. C-HPFH is clinically mild.