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Sir.—I want to make a brief comment about the statement that citrate agar electrophoresis at a pH of 6.2 will permit differentiation of sickle cell anemia from Hb S/HPFH and Hb S/β thalassemia that appeared in the editorial by Miller in the December 1979 issue of the Journal (1979;133:1235-1236).
Citrate agar electrophoresis at an acid pH may permit the clear recognition of small amounts of Hb A and Hb S in cord blood and aid in the diagnosis of sickle-β+ thalassemia. However, citrate agar electrophoresis (in cases with an absence of Hb A) will not permit the differentiation of homozygous sickle hemoglobinopathy from sickle-β° thalassemia, sickle-β°/HPFH, and sickle-δβ thalassemia. The differentiation of homozygous sickle hemoglobinopathy from these syndromes may require other studies, including the quantitation of Hb F and Hb A2, Kleihauer-Betke staining for the study of distribution of Hb F, hematological evaluation (complete blood cell count,
RAO KRP. Screening Newborns for Sickle Cell Anemia. Am J Dis Child. 1980;134(12):1181. doi:10.1001/archpedi.1980.02130240060029