The evaluation of individuals with Coombs-negative chronic hemolysis
Kinetic Spectrophotometry (KS)
Whole Blood ACD-B
Container/Tube:
Preferred: Yellow top (ACD solution B)
Acceptable: Lavender top (EDTA)
Specimen Volume: 6 mL
Collection Instructions: Send whole blood specimen in original tube. Do not aliquot.
If not ordering electronically, complete, print, and send a Benign Hematology Test Request (T755) with the specimen.
1 mL
Gross hemolysis | Reject |
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Whole Blood ACD-B | Refrigerated | 20 days |
The evaluation of individuals with Coombs-negative chronic hemolysis
Hexokinase (HK) is the first enzymatic step in glycolysis, converting glucose to glucose 6-phosphate. Hexokinase deficiency (OMIM 235700) is a rare cause of chronic nonspherocytic hemolytic anemia, and its inheritance is autosomal recessive. Clinically significant HK deficiency manifests in early onset anemia with variable severity ranging from mild to severe. Some patients show neurologic impairment of which the mechanism is unclear.
> or = 12 months: 0.7-1.7 U/g Hb
Reference values have not been established for patients who are younger than12 months.
Clinical correlation or genetic confirmation may be required to establish hexokinase (HK) deficiency as a cause of hemolytic anemia as the assayed activity level in confirmed cases can vary from markedly decreased to borderline normal levels due to a compensated increase in enzyme by reticulocytes. Comparison of HK activity levels to other RBC enzyme activity can be very useful. Heterozygotes have moderately decreased to low normal HK levels and are expected to be clinically unaffected.
Increased HK activity may be seen when reticulocytes are increased and is not supportive of a diagnosis of HK deficiency.
Recent transfusion may mask the patient's intrinsic enzyme activity and cause unreliable results.
Hexokinase (HK) activity level can vary from markedly decreased to borderline normal levels in affected individuals due to a compensated increase in enzyme by reticulocytes. Comparison of HK activity levels to other red blood cell enzyme activity can be very useful.
1. Koralkova P, Mojzikova R, van Oirschot B, et al: Molecular characterization of six new cases of red blood cell hexokinase deficiency yields four novel mutations in HK1. Blood Cells Mol Dis. 2016 Jul;59:71-76
2. Koralkova P, van Solinge WW, van Wijk R: Rare hereditary red blood cell enzymopathies associated with hemolytic anemia-pathophysiology, clinical aspects and laboratory diagnosis. Int J Lab Hematol. 2014;36:388-397
Hexokinase catalyzes the reaction of adenosine triphosphate (ATP) and glucose to glucose 6-phosphate (G6P) and adenosine diphosphate (ADP). In this assay the formation of G6P is measured by linking its further oxidation to 6-phosphogluconate to the reduction of nicotinamide adenine dinucleotide phosphate (NADP[+]) through the G6P dehydrogenase reaction. The increase in absorbance, which occurs as NADP(+) is reduced to NADPH, is measured spectrophotometrically at 340 nm on an automated chemistry analyzer.(Beutler E: Red Cell Metabolism: A Manual of Biochemical Methods. 3rd ed. Grune and Stratton; 1984:40-42; van Solinge WW, van Wijk: Enzymes of the red blood cell. In: Rifai N, Horvath AR, Wittwer CT: eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018:chap 30)
Tuesday, Thursday
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.
82657
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
HK1 | Hexokinase, B | 49216-5 |
Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
---|---|---|
HKCL | Hexokinase, B | 49216-5 |