Screening for presence or absence of hemoglobin (Hb) S (sickle cell disease)
Hemoglobin S Solubility
Sickle Cell Screen
Sickledex
Sickling Test
Hemoglobin,Solubility Test for HbS
Hb S
Hemoglobin S
Sickle Prep
Sickle Solubility
Hemoglobin S Screen
Whole Blood EDTA
This is a screening test only. For quantification of hemoglobin S, order HBEL1 / Hemoglobin Electrophoresis Evaluation, Blood.
1. Patient's age is required.
2. Include recent transfusion information.
Container/Tube:
Preferred: Lavender top (EDTA)
Acceptable: Yellow top (ACD solution B), green top (heparin)
Specimen Volume: 1 mL
Collection Instructions:
1. Invert several times to mix blood.
2. Send whole blood specimen in the original tube. Do not aliquot.
If not ordering electronically, complete, print, and send a Benign Hematology Test Request Form (T755) with the specimen.
0.5 mL
Gross hemolysis | Reject |
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Whole Blood EDTA | Refrigerated | 14 days |
Screening for presence or absence of hemoglobin (Hb) S (sickle cell disease)
Homozygous hemoglobin (Hb) S (sickle cell disease) is a serious chronic hemolytic anemia most commonly found in those of African or Middle Eastern descent.
Hb S is freely soluble when fully oxygenated; when oxygen is removed, polymerization of the abnormal hemoglobin occurs, forming tactoids that are rigid and deformed cells. This leads to sickling of the cells, hemolysis, and many other complications.
Heterozygous Hb S (sickle cell trait) is the most common hemoglobinopathy in the United States. This condition is present in about 8% of African Americans. Usually, Hb S trait exhibits no clinical or hematological effects. A small fraction of people with sickle cell trait have recurrent hematuria.
Negative
A positive result should be followed by a complete hemoglobin (Hb) evaluation (HBEL1 / Hemoglobin Electrophoresis Evaluation, Blood) to confirm the presence and concentration of Hb S.
A positive test is presumptive evidence for hemoglobin (Hb) S (sickle cell disease). However, rare sickling Hbs such as Hb C-Harlem (C-Georgetown) and Hb I will also produce a positive result.
This test only detects the presence of Hb S. It cannot differentiate sickle cell trait (heterozygous Hb S) from sickle cell disease (homozygous Hb S), or Hb S in combination with other abnormalities (eg, S/C, S/D, S/G, S/E, S/beta-thalassemia, S/O-Arab, S/New York, and C-Georgetown trait).
The use of packed red blood cells (RBC) instead of whole blood significantly reduces false negatives due to anemia and false positives due to hypergammaglobulinemia (eg, multiple myeloma).
False positives can occur due to large numbers of nucleated RBC.
False negatives can occur due to an insufficient quantity of Hb S due to age (neonates) or transfusion. Hb S concentrations 15% to 20% or less may give a negative result.
1. Fairbanks VF. Laboratory methods and case studies. In: Decker BC, ed. Hemoglobinopathies and Thalassemias. Thieme-Stratton Inc; 1980:105-107
2. Sauntharajah Y, Vichinsky EP: Sickle cell disease: Clinical features and management. In Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice. 7th ed. Elsevier; 2018:584-607
Hemoglobin S reduced by dithionite is insoluble in concentrated inorganic buffers, and thus, the solution is so turbid that newsprint cannot be read through a tube containing the hemolysate and reagents.(Fairbanks VF, Klee GG: Biochemical aspects of hematology. In: Burtis CA, Ashwood ER, eds. Tietz Textbook of Clinical Chemistry. 3rd ed. WB Saunders Company; 1999: 1678-1679; Greene DN, Vaughn CP, Crews BO, Agarwal AM. Advances in the detection of hemoglobinopathies. Clinica Chimica Acta. 2015; 439:50-57)
Monday through Friday
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.
85660
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
SDEX | Sickle Solubility, B | 6864-3 |
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.
|
---|---|---|
9180 | Sickle Solubility, B | 6864-3 |