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Test Code RBCME Red Blood Cell Membrane Evaluation, Blood

Useful For

Investigation of suspected red cell membrane disorders, such as hereditary spherocytosis or hereditary pyropoikilocytosis

 

This test is not useful for hereditary elliptocytosis.

Profile Information

Test ID Reporting Name Available Separately Always Performed
FRAGO Osmotic Fragility Yes, (Order FRAG) Yes
SCTRL Shipping Control Vial No Yes
HSEV Spherocytosis Interpretation No Yes
BND3 Band 3 Fluorescence Staining, RBC No Yes
SMPB Peripheral Blood Smear Review No Yes

Testing Algorithm

Osmotic fragility and eosin-5-maleimide binding (Band3) flow cytometry testing will always be performed. A normal shipping control is necessary to exclude false-positive results due to preanalytical artifact. Testing will be canceled if no shipping control is received or if the shipping control is abnormal. A consultative interpretation will be provided.

 

For more information see Benign Hematology Evaluation Comparison.

Method Name

HSEV: Medical Interpretation

FRAGO: Osmotic Lysis

BND3: Flow Cytometry

SMPB: Consultant Review

Reporting Name

RBC Membrane Evaluation, B

Specimen Type

Control
Whole Blood EDTA
Whole Blood Slide


Shipping Instructions


Specimens must arrive within 72 hours of collection.



Necessary Information


Include recent transfusion information and most recent complete blood cell count results.

 

Metabolic Hematology Patient Information (T810) is strongly recommended, but not required, to be filled out and sent with the specimen. This information aids in providing a more thorough interpretation of test results. Ordering providers are strongly encouraged to complete the form and send it with the specimen.



Specimen Required


A whole blood EDTA specimen, an EDTA shipping control specimen, and 2 well-made peripheral blood smears (Wright stained or fixed in absolute methanol) are required for testing. The shipping control is used to evaluate whether a patient result has been compromised by handling conditions such as temperature, motion, or other transportation interferences. Temperature and handling extremes can adversely impact the integrity of the specimen.

 

Patient:

Specimen Type: Whole blood

Container/Tube: Lavender top (EDTA)

Specimen Volume: 4 mL

Collection Instructions:

1. Refrigerate specimen immediately after collection.

2. Send whole blood specimen in original tube. Do not aliquot.

3. Rubber band patient specimen and control vial together.

 

Patient:

Specimen Type: Slides

Container/Tube: Blood smears

Specimen Volume: 2 Well-made peripheral blood smears

Collection Instructions:

1. Prepare 2 peripheral blood smears from the EDTA tube collected from the patient.

2. Either stain the smear with Wright stain or fix the smear with absolute methanol prior to shipping.

 

Normal Shipping Control:

Specimen Type: Whole blood

Container/Tube: Lavender top (EDTA)

Specimen Volume: 4 mL

Collection Instructions:

1. Collect a shipping control specimen from a normal (healthy), unrelated, nonsmoking person at the same time as the patient.

2. Clearly hand write "normal control" on the outermost label.

3. Refrigerate specimen immediately after collection.

4. Send control specimen in original tube. Do not aliquot.

5. Rubber band patient specimen and control vial together. The control and patient specimens must be handled in the same manner from specimen collection to receipt in the testing laboratory.


Specimen Minimum Volume

Patient whole blood, shipping control: 2 mL; Slides: See Specimen Required

Specimen Stability Information

Specimen Type Temperature Time Special Container
Control Refrigerated 72 hours PURPLE OR PINK TOP/EDTA
Whole Blood EDTA Refrigerated 72 hours
Whole Blood Slide Refrigerated CARTRIDGE

Reference Values

≥12 months:

0.50 g/dL NaCl (unincubated): 3-53% hemolysis

0.60 g/dL NaCl (incubated): 14-74% hemolysis

0.65 g/dL NaCl (incubated): 4-40% hemolysis

0.75 g/dL NaCl (incubated): 1-11% hemolysis 

NaCl = sodium chloride

An interpretive report will be provided.

 

Reference values have not been established for patients who are younger than 12 months of age.

Interpretation

An interpretive report will be provided.

Clinical Reference

1. King MJ, Garcon L, Hoyer JD, et al: International Council for Standardization in Haematology. ICSH guidelines for the laboratory diagnosis of nonimmune hereditary red cell membrane disorders. Int J Lab Hematol. 2015 Jun;37(3):304-325

2. Lux SE, IV: Anatomy of the red cell membrane skeleton: unanswered questions. Blood. 2016 Jan 14;127(2):187-199 doi: 10.1182/blood-2014-12-512772

3. Gallagher PG: Abnormalities of the erythrocyte membrane. Pediatr Clin North Am. 2013 Dec;60(6):1349-1362

4. Bianchi P, Fermo E, Vercellati C, et al: Diagnostic power of laboratory tests for hereditary spherocytosis: a comparison study in 150 patients grouped according to molecular and clinical characteristics. Haematologica. 2012 Apr;97(4):516-523

Day(s) Performed

Monday through Saturday

Report Available

4 to 7 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

CPT Code Information

85557-Osmotic fragility

88184-Flow cytometry; first cell surface, cytoplasmic or nuclear marker x 1

85060-Morphology review

LOINC Code Information

Test ID Test Order Name Order LOINC Value
RBCME RBC Membrane Evaluation, B 98905-3

 

Result ID Test Result Name Result LOINC Value
83141 Band 3 Fluorescence Staining, RBC 98906-1
9064 Osmotic Fragility, RBC 34964-7
SCTRL Shipping Control Vial 40431-9
13065 Spherocytosis Interpretation 50595-8
37406 Peripheral Blood Smear Review 59465-5
37436 Reviewed By 18771-6
3306 Osmotic Fragility, 0.50 g/dL NaCl 23915-2
3307 Osmotic Fragility, 0.60 g/dL NaCl 23918-6
3308 Osmotic Fragility, 0.65 g/dL NaCl 23920-2
3309 Osmotic Fragility, 0.75 g/dL NaCl 23921-0
3310 Osmotic Fragility Comment 59466-3

Forms

1. Metabolic Hematology Patient Information (T810)

2. If not ordering electronically, complete, print, and send a Benign Hematology Test Request (T755) with the specimen.

Test Classification

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.