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HelpTest Code RBCME Red Blood Cell Membrane Evaluation, Blood
Shipping Instructions
Specimens must arrive within 72 hours of draw.
Necessary Information
Include recent transfusion information.
Include most recent CBC results.
Specimen Required
A whole blood EDTA specimen, an EDTA control specimen, and 2 well-made peripheral blood smears (Wright stained or fixed in absolute methanol) are required for testing.
Specimen Type: Blood
Container/Tube: Lavender top (EDTA)
Specimen Volume: 4 mL
Collection Instructions:
1. Immediately refrigerate specimen after draw. Refrigerate at 0 to 4° 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 refrigerate temperature, carefully following proper handling and shipping instructions.
Patient:
Specimen Type: Slides
Container/Tube: Blood smears
Specimen Volume: 2 well-made peripheral blood smears
Collection Instructions: Collect 2 well-made peripheral blood smears (Wright stained or fixed in absolute methanol).
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. Label clearly on outermost label normal control.
3. Immediately refrigerate specimen after draw. Refrigerate at 0 to 4° 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
1. Metabolic Hematology Patient Information (T810) in Special Instruction
2. If not ordering electronically, complete, print, and send a Benign Hematology Test Request Form (T755) with the specimen.
Useful For
Investigation of suspected red cell membrane disorders such as hereditary spherocytosis or hereditary pyropoikilocytosis
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 (EMA) 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.
See Benign Hematology Evaluation Comparison in Special Instructions.
Special Instructions
Method Name
HSEV: Consultative Interpretation
FRAGO: Osmotic Lysis
BND3: Flow Cytometry
SMPB: Consultant Review
Reporting Name
RBC Membrane Evaluation, BSpecimen Type
ControlWhole Blood EDTA
Whole Blood Slide
Specimen Minimum Volume
2 mL
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Control | Refrigerated | 72 hours |
| Whole Blood EDTA | Refrigerated | 72 hours |
| Whole Blood Slide | Refrigerated | |
Reject Due To
|
Gross hemolysis |
Reject |
|
Other |
Clotted Frozen |
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
An interpretive report will be provided.
Reference values have not been established for patients who are <12 months of age.
Day(s) and Time(s) Performed
Monday through Saturday
Analytic Time
4 days (not reported on Saturday or Sunday)Performing Laboratory
Mayo Clinic Laboratories in Rochester
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.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 | In Process |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 83141 | Band 3 Fluorescence Staining, RBC | In Process |
| 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 | 23917-8 |
| 3308 | Osmotic Fragility, 0.65 g/dL NaCl | 23919-4 |
| 3309 | Osmotic Fragility, 0.75 g/dL NaCl | 30543-3 |
| 3310 | Osmotic Fragility Comment | 59466-3 |