Pitfalls in estimation of glycosylated hemoglobin: A rare hemoglobin variant—Hb Hope

Hemoglobin (Hb) Hope is a rare Hb variant which is clinically silent but causes spuriously high glycated hemoglobin (HbA1c). We report a case of a 45-year-old gentleman, planned for elective total hip replacement, who presented with very high HbA1c with normal blood glucose and fructosamine levels. With the suspicion of erroneous HbA1c, an Hb electrophoresis was done, and he was found to have a rare hemoglobin variant called Hb Hope. We also reviewed almost all case reports of Hb Hope variant causing spuriously high HbA1c levels from India.