Comparison Study of the Eosin-5′-Maleimide Binding Test, Flow Cytometric Osmotic Fragility Test, and Cryohemolysis Test in the Diagnosis of Hereditary Spherocytosis

Abstract

Our results demonstrate that both the EMA binding and FC OF tests are useful as screening tests for the diagnosis of HS, but the cryohemolysis test has limited use due to its false positivity in IDA, with the Hb/MCHC ratio the most useful parameter for assessing the clinical severity of HS.

Percentage of hyperdense cells: Automated parameter to hereditary spherocytosis screening

“…Although current guidelines only mention EMA binding test for screening unusual cases of HS, it is important to consider that FCM OF is a more recent test and there are new studies showing this two tests are equivalent [7,8,14,15]. In this study, different groups of patients based on clinical condition showed a %RC by FCM OF consistent with the reference range in the literature [8].…”

Flow cytometric osmotic fragility test: Increased assay sensitivity for clinical application in pediatric hematology

“…The sensitivity of the test in detecting HS was comparable with values obtained by other studies which were 100% , 93.9% , 91.3% , and 85.7% , respectively. However, it is worth mentioning that those studies were performed mostly in adult patients suffering from HS.…”

Flow cytometric osmotic fragility test and eosin‐5’‐maleimide dye‐binding tests are better than conventional osmotic fragility tests for the diagnosis of hereditary spherocytosis

“…The diagnostic sensitivity of RT‐OFT in our study was 62.06%, which is comparable to ~58%‐60% reported earlier but was lower than ~80% value reported by El‐Gendy et al In our study, sensitivity and specificity of IOFT was 79.3% and 88%, respectively, which were marginally higher than the values of 71.4% and 74.1% reported earlier in an Indian study . The sensitivity of IOFT was also comparable to the range of ~80%‐83% reported in earlier studies but lower than ~100% reported by El‐Gendy et al…”

“…EMA measures the fluorescence intensity of erythrocytes washed and incubated with an eosin‐5′‐maleimide, which is a membrane‐intercalating agent that binds to band 3. EMA gives consistently better results than the classic OFT as shown by many other studies . Fluorescence intensity is expressed as either mean fluorescent intensity (MFI) units or as mean channel fluorescence (MCF) depending on the flow cytometer manufacturer.…”