What likely caused the abnormal hemoglobin electrophoresis results showing elevated A2 and S components?

In evaluating the abnormal hemoglobin electrophoresis results that display elevated A2 and S components, it is important to understand the implications of each component's elevation. The presence of elevated A2 typically indicates β-thalassemia trait or other forms of thalassemia, whereas the presence of the S component suggests the presence of sickle hemoglobin.

The combination of elevated A2 and the S component points towards a disorder that involves an abnormality in β-globin synthesis along with sickle hemoglobin. In sickle cell disorders, particularly Hgb S-β-thalassemia, patients often present with elevated A2 levels due to the impaired production of β-globin chains, which forces the body to produce more A2 (comprised of two alpha and two delta chains) to compensate.

This pattern is notably different from conditions like Hgb Lepore or Hgb SC disease. Hgb Lepore specifically pertains to a different genetic phenotype where crossover events result in hybrid hemoglobins, and although it can show atypical electrophoresis patterns, it would not typically create the specific combination of elevated A2 and S as observed here. Similarly, in Hgb SC disease, while there can be some elevation of A2, the predominant