A report of a case of a patient with diabetes mellitus and unexpectedly low hemoglobin A1c results associated with paroxysmal nocturnal hemoglobinuria (PNH). A study reviews the impact of shortened RBC half-life on the interpretation of hemoglobin A1c levels.
Hemoglobin A1c levels must be interpreted with caution in patients with hematologic diseases that change RBC survival. Serum fructosamine and glycated albumin measurements are alternative measures of time-averaged blood glucose control and may be useful in this subset of patients.
Misleading Hemoglobin A1c Levels in a Patient With Paroxysmal Nocturnal Hemoglobinuria