ACID HEMOLYSIN (HAM TEST)

Code
900.1765
Name
ACID HEMOLYSIN (HAM TEST)
Category
None
Department
Send-Out
Start Date
Expiration Date
Synonyms
Ham Test; Congenital Dyserythropoietic Anemia type II
CPT Codes
85475
Site
SBMF
Reference Test
44336
ATLAS Test Code

Specimen Information

Type

Red top (serum) tube, AND Lavender top (whole blood) tube

*Collect Monday through Thursday only and not the day before a holiday*

Volume

3.0 mL serum (separated from cells), AND 5.0 mL whole blood (EDTA)

Transport Info

Red top: Centrifuge and immediately transfer serum to a separate plastic tube
Room Temperature

Lavendar top: Whole blood
Room Temperature

*Specimens should be received at ARUP Laboratories within 24 hours of collection and testing must be performed within 48 hours of collection*

Fasting Required?
False
Patient Instructions

Reference Range

Negative

Methodology

Visual Identification of Hemolysis

This is an Obsolete test; Flow cytometry is the preferred test for diagnosis of PNH

Clinical Significance

Confirmatory test for Paroxysmal Nocturnal Hemoglobinuria (PNH).

Acidified serum promotes complement binding to red blood cells and complement activation via the alternate pathway. Red blood cells that are hypersensitive to complement-mediated lysis, such as in the clonal disease paroxysmal nocturnal hemoglobinuria (PNH) and in type II congenital dyserythropoietic anemia (CDA) known as HEMPAS (hereditary erythroblast multinuclearity with a positive acid serum test), undergo lysis in ABO-compatible serum at pH 6.5-7.0. The Ham test is a confirmatory test for PNH if preceded by a positive sugar water (sucrose hemolysis) screening test. PNH cells may show lysis in either autologous or heterologous serum. The Ham test may also be applied in suspected cases of CDA, and when positive in this setting, is diagnostic of HEMPAS. Unlike PNH, HEMPAS does not have a positive sugar water test and does not show lysis in acidified autologous serum.

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