Korean J Lab Med.  2010 Aug;30(4):339-344. 10.3343/kjlm.2010.30.4.339.

Flow-Assisted Differential Diagnosis of Hemolytic Anemia with Spherocytosis: A Case Report

• Won DI

• KMID: 1781638
• DOI: http://doi.org/10.3343/kjlm.2010.30.4.339

Abstract

In patients with hemolytic anemia associated with spherocytosis, differential diagnosis has to be made whether the hemolysis is immune-mediated or of non-immune origin. We report a case of hereditary spherocytosis in a 12-yr-old male child, in whom flow-assisted diagnosis was made. In this case, diagnosis was not determined because routine laboratory workups for hereditary spherocytosis yielded discrepant
RESULTS
positive osmotic fragility test, positive direct antiglobulin test, and normal result in the red cell membrane protein sodium dodecyl succinimide polyacrylamide gel electrophoresis. However, all flow cytometry-based tests, such as osmotic fragility, direct antiglobulin, and eosin 5-maleimide binding test, yielded results compatible with hereditary spherocytosis. Additionally, in family study, the results of eosin 5-maleimide binding test suggested his disease being hereditary. In cases with diagnostic difficulties, flow cytometry may be used as an alternative tool, which can provide additional information in the differential diagnosis of hemolytic anemia with spherocytosis.

Keyword

Hemolytic anemia; Hereditary spherocytosis; Flow cytometry

MeSH Terms

Anemia, Hemolytic/complications/*diagnosis
Child
Coombs' Test
Diagnosis, Differential
Eosine Yellowish-(YS)/analogs & derivatives/chemistry
Erythrocytes/immunology/metabolism
Flow Cytometry
Humans
Male
Osmotic Fragility
Spherocytosis, Hereditary/complications/*diagnosis