Hemoglobin G trait and S trait in the same patient.

We describe a subject who had a positive sickle solubility test and a routine alkaline electrophoretic pattern showing three major hemoglobulin bands migrating to the A, S, and A2 positions. In addition, the non-heme protein carbonic anhydrase appeared to be increased, suggesting the presence of a split A2. Two major hemoglobin bands separated on agar gel electrophoresis using a citrate buffer, pH 6.2. A non-S hemoglobin migrating to the position of Hb S was identified as GPhiladelphia. The electrophoretic pattern of GPhil/S trait most closely resembles S/beta+ thalassemia or sickle cell trait. Careful study is essential to avoid misdiagnosis and unfairly stigmatizing patients whose benign abnormality may be confused with more severe disease entities.