Which of the following conditions would be associated with a decreased osmotic fragility test?
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Useful For Suggests clinical disorders or settings where the test may be helpful Profile Information A profile is a group of laboratory tests that are ordered and performed together under a single Mayo Test ID. Profile information lists the test performed, inclusive of the test fee, when a profile is ordered and includes reporting names and individual availability.
Method Name A short description of the method used to perform the test Osmotic Lysis NY State Available Indicates the status of NY State approval and if the test is orderable for NY State clients. Yes Reporting Name Lists a shorter or abbreviated version of the Published Name for a test Osmotic Fragility, RBC Aliases Lists additional common names for a test, as an aid in searching FRAGILITY, OSMOTIC (RBC) RBC Fragility, Erythrocytes Red Cell Fragility Specimen Type Describes the specimen type validated for testing Control Whole Blood EDTA Shipping Instructions Specimens must arrive within 72 hours of collection. Necessary Information Patient's age and sex are required. Specimen Required Defines the optimal specimen required to perform the test and the preferred volume to complete testing Both a whole blood EDTA specimen and a control specimen are required as temperature extremes can increase the fragility of the specimen and cause false-positive results. Patient: Container/Tube: Lavender top (EDTA) Specimen Volume: 4 mL Collection Instructions: 1. Immediately refrigerate specimen after collection. Refrigerate at 0 to 4 degrees C. Do not freeze. Freezing causes sample lysis, and tests will not be performed on hemolyzed specimens. 2. Send specimen in original tube. Do not aliquot. 3. Rubber band patient specimen and control vial together. Control must accompany the patient sample at all times to ensure the reliability of testing results. 4. Be sure specimen and control are stored and transported together at refrigerated temperature, carefully following proper handling and shipping instructions. Normal Shipping Control: Specimen Type: Whole blood Container/Tube: Lavender top (EDTA) Specimen Volume: 4 mL Collection Instructions: 1. Draw a control specimen from a normal (healthy), unrelated, nonsmoking person at the same time as the patient. 2. Handwrite "normal control" clearly on the outermost label. 3. Immediately refrigerate specimen after collection. Refrigerate at 0 to 4 degrees C. Do not freeze. Freezing causes sample lysis, and tests will not be performed on hemolyzed specimens. 4. Send specimen in original tube. Do not aliquot. 5. Rubber band patient specimen and control vial together. Control must accompany the patient sample at all times to ensure the reliability of testing results. Forms Specimen Minimum Volume Defines the amount of sample necessary to provide a clinically relevant result as determined by the Testing Laboratory 2 mL Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included
Useful For Suggests clinical disorders or settings where the test may be helpful Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test Spherocytes are osmotically fragile cells that rupture more easily in a hypotonic solution than do normal RBCs. Because they have a low surface area:volume ratio, they lyse at a higher osmolarity than do normal discocyte (RBCs). Cells that have a larger surface area:volume ratio, such as target cells or hypochromic cells are more resistant to lysing. After incubation, an increase in hemolysis is seen in spherocytes. Hereditary spherocytosis typically has greater number of spherocytes than other causes of spherocytosis. Therefore, the degree of lysis is usually more pronounced, but this is not always the case. Some rare disorders can also cause marked fragility and hereditary spherocytosis cases can display moderate fragility. Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this. > or =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 Reference values have not been established for patients who are <12 months of age. Interpretation Provides information to assist in interpretation of the test results An interpretive report will be provided. Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances Spherocytosis of any cause will result in increased osmotic fragility. Infrequently, other congenital hemolytic disorders may also be associated with positive results, as in patients with congenital nonspherocytic hemolytic anemia due to RBC enzyme deficiencies. Patients with an immunohemolytic anemia, or who have recently received a blood transfusion may also have increased RBC lysis. Resulting Cautions: Osmotic fragility results will be reported if the shipping control is normal. If the shipping control is abnormal and the osmotic fragility results on the patient are within normal range, the results will be reported; however, a comment will be added to the report indicating that the shipping control was not entirely satisfactory. The test will be cancelled if the patient specimen and shipping control are both abnormal. Clinical Reference Recommendations for in-depth reading of a clinical nature Palek J, Jarolin P: Hereditary spherocytosis. In Hematology. Fourth edition. Edited by WJ Williams, E Beutler, AJ Erslev, MA Lichtman. New York, McGraw-Hill Book Company, 1990, pp 558-569 Method Description Describes how the test is performed and provides a method-specific reference Specimens for erythrocyte osmotic fragility tests are anticoagulated with EDTA. Osmotic lysis is performed using sodium chloride (NaCl) solution, 0.50 g/dL. An incubated fragility test is performed following 24-hour incubation at 37 degrees C at the following NaCl concentrations: 0.60, 0.65, and 0.75 g/dL. Results are reported and interpreted.(Larson CJ, Scheidt R, Fairbanks VF: The osmotic fragility test for hereditary spherocytosis: use of EDTA-anticoagulated blood stored at 4 degrees C for up to 96 hours. Am Soc Clin Pathol Meeting Abstract, 1988; Larson CJ, Scheidt R, Fairbanks VF: The osmotic fragility test for hereditary spherocytosis: objective criteria for test interpretation. Am Soc Clin Pathol Meeting Abstract, 1988) PDF Report Indicates whether the report includes an additional document with charts, images or other enriched information No Day(s) Performed Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day. Monday through Saturday Report Available The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing. 2 to 5 days Specimen Retention Time Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded 1 week Performing Laboratory Location Indicates the location of the laboratory that performs the test Rochester Fees Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.
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