Causes of an Elevated Hemoglobin F

Hemoglobin F is typically seen in the fetus but it may be encountered in a number of conditions.

Hemoglobin F related to a fetus or newborn:

(1) fetus or newborn

(2) feto-maternal hemorrhage

Hemoglobin F beyond the newborn may be seen in:

(1) hereditary persistence of fetal hemoglobin (HPFH)

(2) thalassemia

(3) hemoglobin S

(4) mixed

HPFH	Percent Hemoglobn F	Distribution of Hemoglobin F in RBCs
deletional trait	20 to 40%	pancellular
nondeletional trait	3 to 30%	pancellular or heterocellular
deletional homozygous	100%	pancellular

Thalassemia	Percent Hemoglobn F	Distribution of Hemoglobin F in RBCs
beta trait	< 10%	heterocellular
delta/beta trait	5 to 20%	heterocellular
homozygous delta/beta	100%	pancellular
homozygous beta	30 to 90%	pancellular or heterocellular

Hemoglobin S	Percent Hemoglobn F	Distribution of Hemoglobin F in RBCs
homozygous	5 to 30%	heterocellular

Mixed	Percent Hemoglobn F	Distribution of Hemoglobin F in RBCs
hemoglobin S and beta thalassemia	5 to 30%	heterocellular
hemoglobin S and HPFH	20 to 40%	pancellular
hemoglobin E and beta0 thalassemia	10 to 50%	heterocellular
hemoglobin C and beta0 thalassemia	10 to 30%	heterocullular

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