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Home > Conditions & Concerns > Diagnostic Tests > Blood : Special Tests

Blood: Special Tests

Special Hematological Tests 

1. Sickle Cell Anemia Screening.

2. Determination of Fetal Hemoglobin.

3. Determination of Osmotic Fragility of Red Blood Cells.

4. Determination of Lupus Erythematosus (LE) Cell.

5. Determination of Heinz Bodies.

6. Determination of Blood Parasites.

7. Determination of Glucose - 6 - Phosphate Dehydrogenase  (46-PD).

8. Determination of Iron and Total Iron Binding Capacity (TIBC) in Serum.

9. Determination of Electrophoretic Fractionation of Hemoglobin.

10. Microscopic Examination of Bone Marrow and Detection of Iron.

11. Different tests to be performed in Different Bleeding Disorders.

Sickle Cell Anemia Screening

1. Normal blood does not have sickle cells.

2. Clinical findings in S C Anemia.

3. Normocytic, normochromic red cells.

4. Presence of nucleated RBC, sickle cells and Howell-Jolly bodies.

5. Increased reticulocytes.

6. Increased platelets.

7. Decrease in osmotic fragility of RBC.

8. Hemoglobin electrophoresis shows particular hemoglobin.

9. Positive sickle cell test.

Determination Of Fetal Hemoglobin

High level of fetal hemoglobin (HBF) is found in b-thalassemia major patient. 

Mild but significant rise is observed in (HBF) in b-thalassemia trait, sickle cell disease and in other congenital or acquired hematological conditions.

Various percentage of HBF observed.

Determination Of Osmotic Fragility Of Red Blood Cells 

This is useful in determining hereditary spherocytosis, thalassemia and sick cell anemia.  Here the Median Corpuscular Fragility (MCF) is determined.

Determination Of Lupus Erythematosus (LE) Cell 

Lupus Erythematosus  is a disorder of collagen.  Collagen is a fibrous, insoluble protein in connective tissue. 

If the test shows the presence of LE cells, it indicates the disorder.

Determination Of Heinz Bodies

It is useful in detecting metabolic defects caused due to the deficiency of G-6 - PD or glutathione.

The test is positive even when a patient is undergoing therapy with drugs such as anti-malarials and suphonamides.

Detection Of Blood Parasites

Given in Routine Hematological (Blood) Tests.

Determination Of Glucose - 6 -  Phosphate Dehydrogenase (G6 - PD)

Glucose - 6 - phosphate dehydrogenase deficiency is hereditary disorder.  Presence of this enzyme is required in red blood cells to protect hemoglobin from oxidation.  Absence  of this enzyme is harmless unless red blood cells are exposed to antipyretics, anti-malarial drugs and sulphonamides. 

Determination Of Iron And Total Iron Binding Capacity (TIBC) In Serum

Normal Values - 

Serum Iron - 60 -150 mg/dl

Serum TIBC - 270 - 380 mg/dl

	Decrease in the serum iron level is due to chronic blood loss or nephrosis (any disorder of the kidney that is caused by any degenerative process other than infections).
	Increase in the serum iron level is due to hemolytic anemia, lead poisoning, pyridoxine deficiency, pernicious anemia and necrotic hepatitis.  (Necrosis means death of a small area of tissue within an organ).
	Decrease in serum.  TIBC is found in cirrhosis (a type of permanent and progressive liver damage), hemochromatosis and nephrosis.
	Increase in serum TIBC is found in different states of chronic iron deficiency and nephrosis.

Determination Of Electrophoretic Fractionation Of Hemoglobin

Hemoglobin is a conjugated protein when it is subjected to an electrical field, the different proteins depending upon their speeds towards the anode (at pH 8.9).

Normal and abnormal hemoglobin have different velocities.  This helps in identifying congenital disorders of hemoglobin.

Microscopic Examination Of Bone Marrow And Detection Of Iron

This test is conducted in  various anemias like aplastic, megaloblastic, sideroblastic.  It is also done in acute leukemias, multiple myeloma (malignant tumor of the bone marrow) and diseases of the reticuloendothelial system (network of very thin tissue that lines the lymphatic and blood vessels, the heart and various other body cavities). 

In iron deficiency anemias, iron is very low but in sideroblastic anemia it is increased.

Different Tests To Be Performed In Different Bleeding Disorders

Bleeding Disorder	Laboratory Test
i) Vascular defect platelet defect.	Bleeding time.
ii) Coagulation factor deficiency.	Clotting time Plasma recalcification time Activated partial thromboplastin time test (APTT)
iii) Liver disorder and Vitamin K deficiency.	(Increased) APTT (Increased) prothrombin time
iv) Hemophilia (Antihemophilic factor 'A' [AHF] deficiency).	Clotting time  APTT
v) Excessive fibrinolysis.	Clot lysis test Protamine sulphate test
vi) Christmas disease (Plasma thromboplastin component (PTC) or antihemophilic factor 'B' or Christmas factor.	Antihemophilic factor 'B' assay
vii) Von Willebrand's disease (vWD).  It is combination of vascular defect, platelet defect and antihemophilic factor 'A'[AHF]  deficiency.	(Abnormal)Bleeding time (Abnormal) Clotting time (Increased) APTT (Platelet count normal)