Hematology Test

Hematology Test

APT test/Swallowed

Blood syndrome Test/ Fetal hemoglobin

Test

APT test/Swallowed Blood syndrome Test/ Fetal hemoglobin

Indication

This test is done to diagnose swallowed blood syndrome and differentiate this

condition from gastrointestinal hemorrhage in the new born.

Physiology

This test uses alkali denaturation of fetal hemoglobin to determine if blood is

present in the stool of a newborn as a result of swallowing maternal blood or

is due to perinatal or neonatal Gastro-intestinal hemorrhage. In swallowed

blood syndrome, blood or bloody stools are passed usually on the second or

third day of life. The blood may be swallowed during delivery or may be from a

fissure of the mother’s nipple. The test is based on the fact that the infant’s

blood contains > 60% fetal hemoglobin that is alkali resistant. Swallowed

blood of maternal origin contains adult hemoglobin, which is converted to

brownish alkaline hematin on the addition of alkali.

Normal

Range Report will provide indication if blood

is of maternal or infant origin (adult or fetal hemoglobin).

Auto hemolysis Test

Test

Auto hemolysis Test

Indication

This test is used to diagnose hereditary spherocytosis, spontaneous hemolysis,

RBC enzyme deficiency and hemolytic anemia.

Physiology

This test measures the degree to which patients red cells lyse without

additives, with glucose and with ATP (Adenosine Tri-phosphate).

Interpretation

Glucose by itself can induce hemolysis in auto hemolysis test in patients with

hereditary spherocytosis. Glucose-6-Phosphate dehydrogenase deficient RBC’s

have increased auto hemolysis, which corrects significantly with glucose or

ATP. Pyruvatekinase deficiency has increased auto-hemolysis, which does not

correct or get aggravated with glucose but does correct toward normal with ATP.

Related

Tests Glucose-6-Phosphate dehydrogenase

Osmotic Fragility, Red Blood Cell Morphology, RBC enzyme deficiency.

Blood volume/Plasma

volume

Test Blood

volume/Plasma volume

Indication The test

measures the patient's total circulating volume of blood and/or fractions of

the blood volume.

Physiology A component of

the blood (e.g., Albumin) is labeled using a radioisotope. The dilution of the

label is inversely proportional to the size (Volume) of the compartment in

which it has been diluted.   

Interpretation This test

differentiates relative from absolute polycythemia. Polycythemia is increased

red cells and is opposite to anemia. Polycythemia is usually considered when

hemoglobin is 18g/dL, hematocrit is 52% and RBC count is 6 million/mm3.

Test Results Dilution

Technique using 125I – tagged albumin and/or 51Cr-tagged Red Blood Cells.

Related Tests Erythropoietin

Test, Hematocrit Test, Peripheral Blood, Red Cell Mass.

Blood Plasma Volume - Normal

Range

Normal values

Men ml/kg 

Women ml/kg

Blood

volume

61.54 ± 8.59

58.95 ±

4.94

Erythrocyte

volume

28.27 ± 4.11

24.24 ±

2.59

Plasma

volume

33.45 ± 5.18

34.77 ±

3.24

Body Fluid Analysis, Cell count.

Test Body Fluid Analysis, Cell count.

Indication This test is used to evaluate body

fluids, differential diagnosis of exudates and transudate.  

Related Tests Body fluid amylase,

Blood Glucose, Blood pH, CSF analysis, Synovial Fluid analysis.

Blood Fluid Analysis - Normal Range

Type

of fluid

Appearance 

Amount

Cells

Total protein

Pleural 

Clear, colorless to pale yellow

1-10 ml

<1000/mm3;

< 25% polys RBC

-

Peritoneal

Clear, colorless to pale yellow

< 100 ml

< 500/mm3;

< 25% polys;

< 100,000 RBC/mm3

-

Pericardial

Clear, colorless to pale yellow

<500WBC/mm3;

< 25% polys RBC

-

Synovial

No crystals

< 4 ml

<200WBC/mm3;

< 25 Polys

1-3 g/dL

Cold Hemolysin Test/

Donath-Landsteiner Test/PCH Test/ D-L antibody test, Paroxysmal cold

Hemoglobinuria.

Test

Cold Hemolysin Test/ Donath-Landsteiner Test/PCH Test/ D-L antibody test,

Paroxysmal cold Hemoglobinuria.

Indication

This test is to detect Paroxysmal Cold Hemoglobinuria (PCH), a condition caused

by sensitization of RBC (at temperature less than 30°C) by complement binding

IgG biphasic hemolysin.

Normal

Range Negative

Test

Method Observation of Red Cell lysis from patients’

cold activated serum.

Complete

Blood Count/ Blood Cell Profile/ Blood Count/ CBC/ Hemogram

Test Complete Blood Count/ Blood Cell

Profile/ Blood Count/ CBC/ Hemogram

Indication This test is used to evaluate

anemia, leukemia, reaction to inflammation and infections, peripheral blood

cellular characters, State of hydration and dehydration, Polycythemia,

Hemolytic disease of the newborn, to manage chemotherapy decisions.  

Interpretation Presence of one or more of the

following may be indications for further investigations: Hemoglobin <10 g/dL,

>18g/dL. MCV > 100 fL, <80 fL, MCHC >37%, WBC > 20,000/mm3,

<2000/mm3, presence of sickle cells, significant spherocytosis, basophilic

stippling, Stomatocytes, Schistocytosis, Oval macrocytes, Eosinophilia

(>10%), Monocytosis (>15%), toxic granulation.

Critical

Values

Hematocrit <18% or 54%, Hemoglobin <6g/dL or >18g/dL, WBC 2500/mm3 or

>30000mm3, Platelets<20,000/mm3 or > 1,000,000/mm3

Related

Tests Eosinophil

Count, Hematocrit, Hemoglobin, Differential Leukocyte Count, RBC Morphology,

Platelet count, Platelet sizing, Red cell count, White blood count

Eosinophil

count/ Absolute Eosinophil count/ EOS count.

Test Eosinophil count/ Absolute

Eosinophil count/ EOS count.

Indication Eosinophil test is used to

diagnose allergy, drug reactions, Parasitic infections, collagen disease,

Hodgkins disease, Myelo-proliferative diseases.

Normal

Range 50-350/mm3.

Interpretation Eosinophils are increased in

actue hypereosinophilic syndrome, angioneurotic edema, acute renal allograft

rejection, eosniophilic non-allergic rhinitis, eosinophilic gastroenteritis,

eosinophilia myalgia syndrome. Eosinophils are decreased in Cushing’s disease

(Hyper-adrenalism).

Related

Tests Complete

Blood Count, Eosniophil smear, Peripheral blood

Eosinophil

Smear/Fecal smears for Eosinophils.

Test

Eosinophil Smear/Fecal smears for Eosinophils.

Indication

To detect the presence of Eosinophils in sputum and Faeces.

Normal Range

No Eosinophils detected.

Interpretation

Eosinophils mostly increased in blood and sputum of patients with asthma. Levels

of increase by 80% of Eosinophils in sputum are diagnostic of asthma or chronic

bronchitis with wheezing.

Related Tests

Nasal smear for Eosinophils, Sputum smears for Eosinophils

Fetal

Hemoglobin/ HbF.

Test

Fetal Hemoglobin/ HbF.

Indication

The test is used to evaluate hemaglobinopathies, hemolytic anemia, hereditary

persistence of fetal hemoglobin, Thalassemia.

Physiology

Fetal hemoglobin is formed of two α-chains and two γ-chains. It is the major

hemoglobin during fetal life. HbF levels decrease after birth by 3% to 4% each

week. In 2-3 weeks fetal hemoglobin is about 65%. By 6 months of age fetal

hemoglobin is < 2% of the total hemoglobin.

Normal Range

0 – 6 months: Upto 75% of HbF, 6 months - Adult: Up to 2% HbF

Related Tests

Hemolytic disease of newborn, Kleinauer-betke, Sickle Cell test

Folic

acid, serum/Folate level, Serum folate

Test

Folic acid, serum/Folate level, Serum folate

Indication

This test is done to detect the folate deficiency, monitor therapy with folate,

evaluate megaloblastic and macrocytic anemia, and evaluate alcoholic patients

with prior jejuno-ileal for morbid obesity or those with intestinal blind-loop

syndrome.

Physiology

Naturally occurring folates are present widely in plant and animal foods taken

in the diet and absorbed in the small intestine. Lack of folic acid inhibits

DNA synthesis in rapidly dividing cells, thus producing Megaloblastic anemia.

Normal Range

> 2ngl/mL, (S.I. Units - > 5 nmol/L)

Test Method

Competitive Protein binding Radio Immunoassay.

Glucose

– 6- Phosphate Dehydrogenase Screen, Blood.

Test Glucose – 6- Phosphate

Dehydrogenase Screen, Blood.

Indication This test is used to detect drug

sensitive populations of Red cells due to G-6-PD deficiency; to determine the

cause of hemolysis. G-6-PD deficient hemolysis may also be secondary to acute

bacterial or viral infections and metabolic disorders such as acidosis.

Physiology G-6-PD quantitation may be

useful if deficiency is detecting in screening test.

Normal

Range G-6-PD

enzyme activity detected.

Test

Method

Fluorescent NADPH spot test.

Related

Tests G-6-PD,

Quantitative, RBC enzyme deficiency

Glucose

–6- Phosphate Dehydrogenase, Quantitative/ G-6-PD

Test Glucose –6- Phosphate

Dehydrogenase, Quantitative/ G-6-PD

Indication This test is to evaluate G-6-PD

deficiency, determine the cause of drug induced hemolysis or hemolysis

secondary to acute bacterial or viral infections or metabolic disorders such as

acidosis. Mutations responsible for the G-6-PD deficient state can be

identified by use of molecular biologic techniques

Physiology G-6-PD hemolysis is associated

with formation of Heinz bodies in peripheral RBC’s. Quantitative G-6-PD is

helpful in establishing diagnosis of mild G-6-PD deficiency who have had recent

hemolysis.

Normal

Range 8.34 ±

1.59 IU/g hemoglobin

Test

Method Measure

the formation of NADPH following change in absorbance at 340 nm at 370C

HAM

Test/ Acid Serum Test/ PNH Test/ Paroxysmal Noctural Hemoglobinuria test, Serum

lysis.

Test HAM Test/ Acid Serum Test/ PNH

Test/ Paroxysmal Noctural Hemoglobinuria test, Serum lysis.

Indication HAM test is used to evaluate

patients with suspected PNH (Paroxysmal Noctural Hemoglobinuria) or suspected

congential dyserythropoietic anemia, especially with hemosiderinuria,

Pancytopenia, decreased RBC acetyl cholinesterase, decreased leukocyte alkaline

phosphatase, negative direct Coomb’s test, and/or apparent marrow failure.

Physiology Diagnosis of PNH shows that the

suspected patient’s red cells have a high sensitivity to complement mediated

hemolysis. Partial hemolysis occurs with hereditary erythroblastic

multinuclearity disease. PNH is a disease of increased complement sensitivity

of red ell membranes, granulocytes and platelet membrane.

Normal

Range Positive

test result shows lysis of Red cells in acidified serum samples with patients

cell (not with normal cells).

Test

Method Acidified

Serum test of HAM.

Related

Tests Peripheral

blood/ RBC Morphology/ Sugar Water test screen

Heinz

Body Stain

Test

Heinz Body Stain

Indication

This test is used to detect hemolytic disorders associated with Heinz body

formation.

Physiology

Heinz bodies are intra-erythrocytic insoluble inclusions of oxidatively

denatured hemoglobin. They reflect the presence of metabolic derangement of or

abnormality in the secondary structure of hemoglobin.

Normal Range

No Heinz bodies identified.

Interpretation

Heinz bodies are present during G-6-PD deficiency, Heinz body hemolytic anemia

(HBHA). Oxidative denaturation of hemoglobin leads to formation of Heinz

bodies.

Test Method

Supra vital stain.

Related Tests

G-6-PD, Hemoglobin, RBC Morphology, Reticulocyte Count, RBC enzyme deficiency

Hematocrit

/ Hct/ Microhematocrit /PCV/ Packed Cell Volume

Test

Hematocrit / Hct/ Microhematocrit /PCV/ Packed Cell Volume

Indication

Hct is used to evaluate anemia, Blood loss, hemolytic anemia, Polycythemia.

Physiology

Hematocrit is the percent of whole blood that is RBC’s. A determination that is

of importance in the detection and follow up of anemia and Polycythemia. The

hematocrit value is used in the calculation of MCV and MCHC.  

Test Method

Manual Microhematocrit Centrifugation, Automated Electronic Cell Counter.

Related Tests

Blood volume, Complete Blood Count, Hemoglobin, RBC Morphology, RBC indices,

Red Cell count, Reticulocyte count.

Hemoglobin

Test/ Hgb

Test Hemoglobin Test/ Hgb

Indication This test determines the

concentration of hemoglobin in whole blood.

Physiology Hgb is the major component of

the red cell and functions to transport O2. It also acts to buffer CO2 formed

during metabolic activity. Hgb level is important in the detection and follow

up of anemia and polycythemia. The Hgb value is used in the calculation of MCH

and MCHC.

Normal Range

Men 15.5±1 Women 13.7

Interpretation Red cell indices, MCH and MCHC,

depend on the Hgb for their derivative and are of use in the evaluation of

anemia.

Test

Method

Spectrophotometry at 540 nm.

Related

Tests Complete

Blood Count, Erythropoietin, Ferritin, Folic acid, Hematocrit, O2 Saturation,

P-50 blood gas, RBC indices, RBC, RBC count, RBC Mass, Reticulocyte Count,

Sickle Cell Tests, Vitamin B12.

Kleihauer-Betke/

Acid Elution for Fetal Hemoglobin/K-B

Test Kleihauer-Betke/ Acid Elution

for Fetal Hemoglobin/K-B

Indication Staining of postpartum maternal

blood for identification of percentage of fetal cells present. Determine

possible fetal maternal hemorrhage in the newborn, aid in diagnosis of certain

types of anemia in adults; assess the magnitude of fetal maternal hemorrhage;

calculate dosage of Rh immune globulin to be given.

Physiology The KB test is helpful in

distinguishing some forms of Thalassemia from hereditary persistence of fetal

hemoglobin. The hereditary persistence of fetal hemoglobin reveals a uniform

distribution of fetal hemoglobin in each red cell. By calculating the amount of

fetal blood contamination, the evolution of anti-D antibodies in the post

partum woman and subsequent hemolytic disease of the new born can be prevented.

Normal

Range full-term

newborns: Hb F cells are > 90%; normal adults Hb F cells are < 0.01%.

Test

Method Acid

elution test.

Related

Tests Du, Fetal

hemoglobin, Rho (D) Immune Globulin, Rosette Test for Fetomaternal Hemorrhage

LE

cell Test/ Lupus Test

Test LE cell Test/ Lupus Test

Indication Evaluate autoimmune diseases,

Systemic Lupus erythrematous and in the diagnosis of “lupoid” hepatitis (Chronic

active hepatitis).

Physiology SLE is a disease of protean

clinical manifestations commonly with rash, arthralagia, fever, anemia,

leukopenia, thrombocytopenia, and hypocomplementemia. The patient’s serum

should be studied for antinuclear antibody (ANA). The antibody may be IgG, IgA,

or IgM specificity but is most commonly of IgG class.

Normal

Range Negative.

Test

Method Blood

cells are ruptured and nuclear material is released, which interacts with

specific antibody by phagocytosis.

Related

Tests Anti-DNA,

Antinuclear Antibody, Scleroderma Antibody, Sjogren’s Antibodies, Smooth Muscle

Antibody

Leukocyte

Alkaline Phosphatase/ LAP, LAP Smear

Test Leukocyte Alkaline Phosphatase/

LAP, LAP Smear

Indication A cytochemical reaction is

useful in differential diagnosis of myeloproliferative disease, distinguishing

leukemoid reaction from leukemia. Helps in the differential diagnosis of

chronic granulocytic leukemia versuys leukemoid reaction, aids in the

evaluation of polycythemia and myelobrois.

Normal

Range counts of

11 to 95

Interpretation Low scores have been associated

with CML, PNH, thrombocytopenic purpura, and hereditary phpophosphatasia. In

CML regardless of the total white count, the score remains low.

Test

Method Enzyme

reaction with leukocyte alkaline phosphatase liberating naphthol –

Spectrophotometer assay.

Related

Tests Leukocyte

cytochemistry, White Blood Count

Leukocyte

Cytochemistry/ Cytochemistry, Leukocyte.

Test Leukocyte Cytochemistry/

Cytochemistry, Leukocyte.

Indication Test evaluate neoplasm and

abnormal cells in bone marrow, peripheral blood, or other specimens such as

imprints, detect amylodois, classify leukemias and plasma cell dyscrasias, and

evaluate myeloproliferative disorders.

Interpretation For each type of leukemic blast

a consistent and distinctive pattern of non specific esterases activity has

been reported. Isoenzyme fractions of acid phosphatases and nonspecific

esterases appear to be unique for lymphoblasts, myeloblasts, and immature or

leukemic monocytes.

Related

Tests Leukocyte

Alkaline Phosphatase, Muramidase, Peripheral blood differential leukocyte

count, Tartarate resistant Leukocyte Acid phosphatase, White Blood count.

Malaria

Smear/ Blood smear for malarial parasites/ malarial parasites

Test Malaria Smear/ Blood smear for

malarial parasites/ malarial parasites

 Indication

Diagnose malaria, parasitic infestation of blood; evaluate febrile disease of

unknown origin.

Physiology Proper therapy depends upon

identification of the specific variety of malaria parasite. Release of

trophozoites and RBC debris result in a febrile response. Periodicity of fever

correlates with type of malaria. Parasites are most likely to be detected just

before onset of fever which is predictable in many cases. Multiple sampling at

different times in the fever cycle may prove successful results.  

Test

Method

Microscopic examination of thick and thin peripheral blood smears stained with

Romanovsky dye. Thick smears are more difficult to interpret but greatly

increase sensitivity. Thick smears require considerable experience with

malaria. Recent techniques: DNA hybridization probes for detection of malarial

parasites

Related

Tests Parasite

Antibodies, Peripheral Blood/Red blood cell Morphology

Nitro-blue

Tetrazolium Test/ NBT Test/ Tertazolium Reduction Test

Test Nitro-blue Tetrazolium Test/ NBT

Test/ Tertazolium Reduction Test

Indication Diagnose Chronic Granulomatous

Disease (CGD) of childhood.

Physiology NBT test is used mainly for the

diagnosis of chronic granulomatous disease; an X linked inherited disease,

characterized by disabled phagocyte NADPH oxidase with inability to efficiently

kill phagocytized bacteria. The CGD may result from genetic defects in atleast

four different components of the multicompotent NADPH oxidase system.

Normal

Range 2% to 8%

segmented neutrophils reduces dye.

Interpretation This test is a reliable aid in

the diagnosis of chronic granulomatous disease in which neutrophils are unable

to reduce the dye. In patients with CGD, the NADPH oxidase system fails to

generate Superoxide and related oxygen intermediates with resultant

susceptibility to recurrent bacterial and fungal infections. Treatment of CGD

patients with recombinant interferon –γ has been shown to result in a near

normal level of Superoxide production and return of granulocyte bactericidal

capacity to normal control levels. Interferon-γ stimulates progenitor cells and

their mature progeny.

Test

Method Chronic

granulomatous disease can now be diagnosed using restriction fragment length

polymorphism with labelled gene probes. The abnormal gene located on the short

arm of the X chromosome codes for cytochrome b558.

Osmotic

Fragility/ Incubated Osmotic Fragility/ RBC fragility/ Red Cell Fragility.

Test Osmotic Fragility/ Incubated

Osmotic Fragility/ RBC fragility/ Red Cell Fragility.

Indication Evaluate hemolytic anemia,

especially hereditary spherocytosis, evaluate immune hemolytic states.

Physiology Hereditary spherocytosis may be

the result of an autosome dominant transmitted detect in red cell structural

proteins. It is associated with a compensated or uncompensated hemolytic state,

which is relieved by splenectomy. Most hereditary hemolytic anemia’s involve

mutations of membrane structural proteins, the majority ode for abnormal

spectrin molecules. A red cell protein 4.2 deficiency has been described. It

has been reported recently found in individuals who have related anemia and

whose red cells show osmotic fragility. Decreased osmotic fragility maybe seen

with iron deficiency, other hemoglobinopathy, hemoglobin C disease, likely due

to the target cell population, and is characteristic of thalassaemia. Osmotic

fragility is increased in cases of malaria infestation.

Normal

Range Hemolysis

begins 0.45%. hemolysis complete 0.35%

Interpretation Percent hemolysis is determined

using optical density measurements.

Related

Tests

Autohemolysis Test, Red Blood Cell Morphology, Reticulocyte Count

Peripheral

Blood: Differential Leukocyte count/ Differential smear/Peripheral differential

White Blood Cell Morphology.

Test Peripheral Blood: Differential

Leukocyte count/ Differential smear/Peripheral differential White Blood Cell

Morphology.

Indication Determine qualitative and

quantitative e variations in white cell numbers and morphology, morphology of

red cells and platelet evaluation; evaluate anemia leukemia, infections,

inflammatory states, and inherited disorders of red cells, white cells, and

platelets.

Interpretation Significantly abnormal findings

should be the subject of further study and review. Changes in leukocyte fractions

are a window to a spectrum of minor to serious physiologic and pathologic

changes.

Test

Method Manual

enumeration of white ells on wright’s stained peripheral blood smear.

Continuous flow system (automated) using cytochemical measurements.

Related

Tests Bacteremia

Detection, Bone marrow, Complete Blood Count, Eosinophil Count, Infectious

Mononucleosis Screening Test, Leucocyte Cytochemistry, Lymph node biopsy,

Lymphocyte subset enumeration, Peripheral Blood Cell Morphology, Platelet and

White Blood Cell Count

Peripheral

Blood: Red Blood Cell Morphology/Blood smear Morphology

Test

Peripheral Blood: Red Blood Cell Morphology/Blood smear Morphology

Indication

This test is used to evaluate red cell disorders, white cell disorders,

platelet disorders.

Normal Range

Normal Morphology

Test Method

Wright’s stained peripheral blood.

Related Tests

Blood volume, Complete Blood Count, Hematocrit, Hemoglobin, Red Blood Cell

indices, Red Cell Count

Platelet

count/ Thrombocyte count

Test Platelet count/ Thrombocyte

count

Indication Test is used to evaluate,

diagnose, and follow up bleeding disorders, purpura/petechiae, drug induced

thrombocytopenia, idiopathic thrombocytopenia purpura, disseminated

intravascular coagulation, leukemia, and chemotherapy management of malignant

disease.

Physiology Platelets are generally 2-3 microns

diameter but large forms appear when production is increased. The production of

platelets is controlled by thrombopoietin. Platelets survive for 8-10 days and

are subject to circadian periodicity highest platelet counts occurring during

midday. Some drugs may increase the platelet count by stimulating

thrombopoietin production.

Normal

Range

150,000-450,000/mm3 (150-450 X109/L or 150,000-450,000

mL)

Interpretation The platelet, of growing

practical clinical importance in hemostatic considerations and a variety of

medical/surgical processes, is also fundamental to etiology considerations of

arteriosclerosis and malignant disease.

Critical

Values

<50,000 mm3 or >1,000,000/mm3

Test

Method Counts

are performed on platelet rich plasma or whole blood by optical or impedance

matching counting techniques.

Related

Tests Complete

blood count/ Intravascular coagulation screen/ kidney profile/ Partial

Thromboplastin Time/ Peripheral blood differential leukocyte count/ Platelet

adhesion test/ Platelet aggregation/ Platelet Antibody/ Platelet Antibody/

Platelet Concentrate/ platelet Sizing

Platelet

Sizing/ Mean Platelet Volume/ Platelet indices

Test Platelet Sizing/ Mean Platelet

Volume/ Platelet indices  

ndication Differential diagnoses of

hematologic disease, assess platelet function, and guide need for platelet

transfusion in thrombocytopenic patients.

Interpretation Large platelets are young

platelets and have better hemostatic function than average age of old

platelets.

Test

Method Flow

cystometry

Related

Tests Complete

Blood Count, Platelet Count

Red

Blood Cell Enzyme Deficiency, Quantitative/ Erythrocyte Enzyme Deficiency/ RBC

enzymes.

Test Red Blood Cell Enzyme

Deficiency, Quantitative/ Erythrocyte Enzyme Deficiency/ RBC enzymes.

Indication The test is used to investigate

hemolytic anemia

Normal

Range G-6-PD:

8.6-18.6 IU/g hemoglobin; Phospho-hexoisomerase: 14.7-42.2 IU/g hemoglobin;

Pyruvate kinase: 2.0-8.8 IU/g hemoglobin.

Interpretation Individuals with low levels of

RBC G6-PD deficiency include: analgesics/antipyretics: aspirin; sulfa drugs:

sulfapyridine, sulfa drugs: sulfapyridine, sulfisoxazole; antimalarias:

primaquine, pentaquine, quinine; nitrofurantoin; Chloromycetin, quinidine,

para-ainosalicyclic acid;others. Deficient or absent RBC enzyme activity may

relate to absence of or decreased level of the enzyme, presence of an inactive

molecular form or of an isoenzymes with altered activity. Glutathione reductase

deficiency also occurred in some cases of malnutrition, liver disease, and

sepsis.

Related

Tests

Auto-hemolysis, Glucose-6-Phosphate Dehydrogenase, Heinz Body Stain, Red Blood

Cell Enzyme Deficiency Screen

Red

Cell Count/ Erythrocyte Count, Red Blood Cell Count

Test

Red Cell Count/ Erythrocyte Count, Red Blood Cell Count

Indication

The test is used to evaluate anemia, polycythemia.

Normal Range

Male: 4.6-6.0 X 106/mm3 ; Female: 3.9-5.5 X 106/mm3

Interpretation

Decrease in RBC count may be due to the result of red cell loss by bleeding or

hemolysis, failure of marrow production, or may be due to secondary dilution

factors (intravenous fluids) Increase in RBC count may be the result of primary

polycythemia including stress. RBC count is normally higher in individuals

residing at high altitudes.

Test Method

Manual haemocytometer chamber count.

Related Tests

Complete Blood Count, Erythropoietin, Ferritin, Hematocrit, Hemoglobin, Red

Blood Cell Morphology, Red Blood Cell indices, Vitamin B12

Red

Cell Mass/ Red Cell Volume

Test

Red Cell Mass/ Red Cell Volume

Indication

The test is used to determine red cell mass, support the diagnosis of

polycythemia and monitor therapy with anti-neoplastic drugs.

Physiology

The assessment of anemia and polycythemia depend foremost upon a reliable and

direct determination of red cell volume. RBC count, Hgb level, and Hct provide

only concentration parameters, the measured number or amount relative to the

solution in which it exists. In a number of clinical situations the RBC count,

Hgb, and Hct will not indicate the actual decrease or increase in circulating

red cell mass.

Normal Range

Male: 24-32 mL/kg; Female: 21-27 mL/kg

Interpretation

Decreased red cell volume includes anemia, nutritional, hemolytic, production

deficit, acute and/or chronic blood loss, acute blood loss, chronic disease ,

radiation, starvation, or severe edema Vs Increased red cell volume include

Polycythemia vera, Secondary polycythemia, hypoxia, methemoglobinemia,

carboxyhemoglobinemia, Erythropoietin producing tumors/cysts, Hereditary over

production of erythropoietin, Stress polycythemia, due to decreased plasma

volume, as in cases of severe dehydration, burns, fluid and electrolyte

abnormalities with Addison’s or Cushing’s diseases.

Related Tests

Blood volume, Erythropoietin, Hematocrit, Hemoglobin

Reticulocyte

Count

Test

Reticulocyte Count

Indication

This test is used to evaluate erythropoietic activity; Increased in acute and

chronic hemorrhage, hemolytic anemias; The Reticulocyte production index will

decide if one is working with a hyper-proliferative or non-proliferative

anemia, and thus, which tests should be subsequently ordered.

Normal Range

Adults: 0.5% to 1.5%; Newborns: <7%; Normal values at birth: 2.5% to

6.5%>

Test Method

Flow cytometery.

Related Tests

Hematocrit Red cell survival, Heinz body, Hematocrit, Hemoglobin, Osmotic

Fragility, Sickle Cell Tests

Schilling

Test/ Vitamin B12 Absorption test

Test

Schilling Test/ Vitamin B12 Absorption test.

Indication

In vivo test for pernicious anemia, vitamin B12 malabsorption, and integrity of

distal small intestine; Use to assess Vitamin B12 absorption in the diagnosis

of malabsorption due to the lack of intrinsic factor, a diagnostic adjunct in

other defects of small intestinal absorption. Evaluate extent of Crohn’s

disease in terminal ileum.

Normal Range

10% excretion in the urine of radioactive B12 indicates intact intrinsic factor

function.

Test Method

Invivo radio-labelled assay

Related Tests

Folic Acid, Intrinsic Factor Antibody, Iron and Total Iron Binding

Capacity/Transferrin, Parietal Cell Antibody, Red Blood Cell Morphology, Red

blood Cell Indices, Vitamin B12, Vitamin B12 Unsaturated Binding Capacity

Siderocyte

Stain/ Hemosiderin Stain/ Iron stain/ Pappenheimer Body stain

Test

Siderocyte Stain/ Hemosiderin Stain/ Iron stain/ Pappenheimer Body stain

Indication

The test is used to identify sideroblastic anemias and hemolytic anemia.

Semi-quantitation of marrow iron stores evaluation of iron reserve, assist in

the diagnosis of iron deficiency and hemosiderosis.

Physiology

Siderotic granules represent iron not yet incorporated into hemoglobin and

occur primarily when there is impaired hemoglobin synthesis. Siderocytes are

uncommon in the peripheral blood unless a splenectomy has been performed on the

patient, Iron stained of bone marrow is more important in terms of deciding on

the cause of anemia.

Normal Range

No siderocytes identified, In bone marrow stainable iron present.

Test Method

Prussian blue reaction.

Related Tests

Iron stain, Bone marrow.

Sugar

Water Test Screen/ PNH Test Screen/ Sucrose Hemolysis Test

Test

Sugar Water Test Screen/ PNH Test Screen/ Sucrose Hemolysis Test

Indication

The screening test for suspected paroxysmal nocturnal hemoglobinuria (PNH).

Confirm the test with Ham Test.

Normal Range

If no hemolysis is present, the patient probably does not have PNH provided

multiple recent transfusions have not reduced the proportion of abnormal cells.

Test Results

If the sugar water test is positive, a subsequent Ham test is strongly

recommended. A negative sugar water test rules out PNH in most instances,

provided the proportion of patient cells has not been reduced by previous

transfusion. It has been demonstrated that the most complement sensitive cells

in PNH are younger RBCs and reticulocytes. Increased sensitivity can be

obtained for the assays by separating young RBCs from old by centrifugation.

Related Tests

Erythrocyte complement fixation Test, Ham Test

Tartarate

Resistant Leukocyte Acid Phosphatase/ Acid phosphatase/ Leukocyte Acid

Phosphatase.

Test

Tartarate Resistant Leukocyte Acid Phosphatase/ Acid phosphatase/ Leukocyte Acid

Phosphatase.

Indication

This test is used to diagnose "hairy cell leukemia"/ "Leukemic

reticuloendotheliosis"

Physiology

There are six isoenzymes of leukocyte acid phosphatase. Isoenzyme V is not

inhibited by L (+) tartaric acid. Malignant nuclear cells of leukemic

reticuloendotheliosis contain isoenzyme V and are resistant to inhibition by L

(+) tartaric acid.

Normal Range

Most white cells of peripheral blood as well as platelets are acid phosphatase

positive.

Test Method

Naphthol AS-BI, fast garnet GBC, with and without L(+) tartaric acid.

Related Tests

Leukocyte Cytochemistry, Lymph node biopsy

Terminal

Deoxynucleotidyl Transferase/ TdT/ Terminal Deoxyribonucleotidyl Transferase/

Terminal Transferase

Test

Terminal Deoxynucleotidyl Transferase/ TdT/ Terminal Deoxyribonucleotidyl

Transferase/ Terminal Transferase

Indication

The test is used to classify certain leukemias and lymphomas, normally used to

distinguish lymphoblastic from non-lymphoblastic leukemia, diagnose acute

lymphoblast leukemia, lymphoid blast crisis of chronic myelogenous leukemia,

and lymphoblastic lymphomas.

Physiology

TdT acts to catalyze the polymerization of deoxynucleoside triphosphates.

Thymus is the primary site of TdT positive cells and TdT is found in the

nucleus of the more primitive T cells. A thymus related population of TdT

positive cells resides in the bone marrow.

Normal Range

Peripheral blood is negative for TdT-positive cells, bone marrow <1.8%

TdT-positive cells.

Interpretation

TdT is increased in more than 90% of the cases of ALL of childhood. This is

true for even pre-B cell as well as B-cells ALL. TdT positive blasts are

prominent in some cases of chronic myelogenous leukemia relating to the

development of an acute blast phase. TdT has been reported to assist in

establishing the diagnosis of acute lymphoblastic leukemia. TdT positive cases

of blast phase CML correlate with a positive response to chemotherapy

vincristine and prednisone.

Test Method

ELISA, Indirect Immunofluorescence antibody,

Related Tests

Bone marrow, Immuno-phenotypic Analysis of Tissues, Lymph node biopsy

Thorn

Test/ Adrenal Function Eosinophil Count

Test

Thorn Test/ Adrenal Function Eosinophil Count

Indication

Eosinophil Count is performed before and 4 hours following an injection of ACTH

as a test of adrenal cortical function.

Interpretation

If adrenal cortical function is normal, the Eosinophil count will act as

follows: The Eosinophil count before the injection will be about twice the

value of the Eosinophil count after the injection. If the adrenal cortical

function is decreased, Eosinophil count before the injection will be

approximately the same as the Eosinophil count after the injection. When

adrenal cortical function is decreased, it indicates hypoadrenalism (Addison’s

disease).

Related Tests

Adrenocorticotropic Hormone, Cortisol, Cosyntropin Test, Eosinophil Count

Viscosity,

Serum/ Serum Viscosity

Test

Viscosity, Serum/ Serum Viscosity

Indication

Test is used to evaluate hyperviscosity syndromes associated with monoclonal

gammopathy syndromes – myeloma, macroglobulinemia & dysproteinemias,

rheumatoid arthritis, systemic lupus erythematosus, hyper-fibrinogenemia.

Physiology

Hyperviscosity is the most frequent with IgM monoclonal gammopathy, next with

IgA myeloma. In IgG myeloma there is an increase in hyper-viscosity IgG levels.

Kappa light chain myeloma is responsible for hyperviscosity syndrome apparently

as a result of true polymer formation.

Test Method

Viscometer.

Related Tests

Immuno-fixation Electrophoresis, Protein Electrophoresis

Viscosity/

Blood viscosity

Test

Viscosity/ Blood viscosity

Indication

Detect hyper-viscosity states in neonatal period

Physiology

Hematological hyper-viscosity syndromes as of polycythemic, sclerocythemic, or

plasma types. The polycythemic category includes syndromes the result of

erythrocytosis, hyperleukocytic leukemia.

Test Method

Micro-viscometer method

Related Tests

Erythropoietin

Vitamin

B12/ Anti-pernicious anemia factor/ Cyanocobalamin

Test

Vitamin B12/ Anti-pernicious anemia factor/ Cyanocobalamin

Indication

The test is used to detect Vitamin B12 deficiency as in pernicious anemia in

those patients who have hematologic symptoms – weakness, anemia,

hyper-segmented neutrophils, leucopenia, or Neurologic – numbness, tingling,

loss of vibratory sensation.

Physiology

Cyanocobalamin analogues from the base compound in coenzymes having important

biologic functions. Vitamin B12 is not synthesized by humans. It is a requisite

dietary component widely available in animal products. The minimum daily

requirement is 1-5 µg/day, body stores are 2000-5000 µg. Vitamin B12 is

absorbed by microvilli of the ileum a pH and divalent cation dependent process.

Normal Range

100-250 pg/mL (74-185 pmol/L)

Interpretation

Vitamin B12 is low in hypochlorhydria, pernicious anemia, intestinal

absorption, inflammatory bowel disease, bacterial infection. Diphyllobothrium

fish tapeworm, intestinal surgery, oral contraceptives, increase in red blood

cell volume. Vitamin B12 is increased in chronic granulocytic leukemia, chronic

renal failure, severe congestive heart failure, diabetes, obesity and liver

cell damage.

Test Method

Radioimmunoassay (RIA)

Related Tests

Complete Blood Count, Folic Acid, Hemoglobin, Intrinsic Factor Antibody, Red

Blood Cell Indices, Schilling Test

White

Blood Count/ Leukocyte Count/ Total WBC/ White Count

Test White Blood Count/ Leukocyte Count/ Total WBC/

White Count

Indication Used to evaluate White cell enumeration, evaluate

myelopoiesis, bacterial and viral infections, toxic metabolic processes,

diagnose leukemia stages.

Physiology WBC counts from actively crying babies may show

leukocytosis and may suggest bacterial infections.

Normal Range Peripheral blood: 4500-11,000/mm3

(4.5-11 X 109/L) Possible Panic Range: < 2500/mm3

(2.5X109/L) or > 30000/mm3 (>30.0X109/L).

Test Method Haemocytometer counting chamber

Related Tests Anti-neutrophil Antibody, Chromosome Analysis,

Complete Blood Count, Total WBC Count

Zeta

Sedimentation Ratio/ Erythrocyte Sedimentation rate/ ZSR

Test Zeta Sedimentation Ratio/ Erythrocyte Sedimentation

rate/ ZSR

Indication The test is a Non-specific indicator of infectious

disease and inflammatory states, reflects acute phase resistant levels, screen

for collagen disease, rheumatoid arthritis

Interpretation Increased in infection, inflammation, tissue

necrosis, macroglobulins are increased. Decreased in – Sickle cell disease and

spherocytosis. The tests ESR, ZSR, and/or CRP are used in the differentiation

of anemia from iron deficiency.

Related Tests Burn culture, C - reactive protein, Erythrocyte

Sedimentation Rate