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Abstract
High-performance liquid chromatography (HPLC) has largely replaced electrophoresis for the identification of hemoglobin (Hb) variants. However, one needs to be vigilant to pick up undue interference such as the presence of a bilirubin peak, which can be mistaken for either Hb Bart's or Hb H on Hb HPLC. Correlation with the clinical context and biochemical parameters, coupled with repeating the run after washing the sample, can resolve this problem. Herein, we report one such case of an acute on chronic liver failure patient who was found to have heterozygous β-thalassemia (β-thal) on Hb HPLC with an incidental tall unknown peak that was identified as bilirubin.