In this case study, we report a β-thalassaemia trait (IVS 1-5G→C) (HBB:c.92 + 5G→C) with HbA<sub>2</sub> of 1% showing the presence of δ-globin gene variant HbA<sub>2</sub> St. George CD 81 (C→T) (HBD:c.244C→T).
Both coinheritance of thalassemic δ-globin mutation and coexistence of iron deficiency anemia (IDA) tend to decrease HbA2 (α2 δ2 ) level and thereby poses a diagnostic conundrum in β-thalassemia trait.