Trace element status in a rare case of hemoglobin D Punjab trait

Hemoglobin D Punjab is a hemoglobin variant that occurs mainly in northwest India with prevalence rate of 1%. Homozygous form is very rare and clinically more serious than heterozygous HbD. Here we present a case of HbD trait with mild anemia and slightly altered red cell indices in a 31year old female from South India. Decreased plasma trace elements (iron, copper, zinc) and altered metalloproteinsare the novel findings, emphasizing the need for periodic assessment and prompt supplementation of micronutrients to prevent red cell damage and related complications in hemoglobinopathies.