ARUP's Laboratory Test Directory

Paroxysmal Nocturnal Hemoglobinuria Panel, RBC and WBC : 2005006
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Additional Technical Information
  


Mnemonic: PNH PAN

Ordering Recommendation: Preferred test for initial diagnosis of paroxysmal nocturnal hemoglobinuria (PNH) and quantification of PNH clones.
Methodology: Quantitative Flow Cytometry
Performed: Sun-Sat
Reported: 1-4 days
Specimen Required: Patient Prep: New York State Clients: Only whole blood testing is acceptable. Specimen must be analyzed within 24 hours of collection if ambient or within 48 hours of collection if refrigerated.

Collect: Lavender (EDTA), pink (K2EDTA), or green (sodium or lithium heparin).

Specimen Preparation: Transport 4 mL whole blood. (Min: 3 mL)

Storage/Transport Temperature: Refrigerated.

Remarks: Specimens must be analyzed within 72 hours of collection.
New York State Clients: Only the whole blood PNH PAN is acceptable and must be analyzed within 24 hours of collection if ambient or 48 hours of collection if refrigerated.

Unacceptable Conditions: Specimens older than 72 hours. Clotted, Hemolyzed or frozen specimens. Bone marrow specimens.
New York State Clients: Specimens for the PNH PAN older than 24 hours ambient or older than 48 hours refrigerated. Clotted, hemolyzed or frozen specimens. Bone marrow specimens.

Stability (collection to initiation of testing): Ambient: 24 hours; Refrigerated: 72 hours; Frozen: Unacceptable. New York State Clients: Ambient: 24 hours; Refrigerated: 48 hours. Frozen: Unacceptable
Reference Interval:
By report
Interpretive Data: This panel is useful in the initial diagnosis of PNH and was developed according to recently published guidelines (Cytometry B Clin Cytom. 2010 Jul; 78(4):211-30); it includes diagnostic WBC analysis and high-sensitivity RBC analysis. WBC analysis is the most accurate measurement of the PNH clone size with a lower limit of detection of 0.1 percent PNH cells and uses FLAER, CD14, and CD24 as GPI-linked markers with CD15 and CD33 as lineage-specific markers. The high sensitivity RBC analysis has a lower limit of detection of 0.005 percent PNH cells and quantifies Type II and Type III RBC populations when the percentage of PNH RBCs is greater than 1 percent. Glycophorin A is used to gate the RBC population. CD59 is the GPI-linked antigen. Recent RBC transfusions may decrease the percentage of PNH cells. (Cytometry 42:223-33, 2000).

This test also detects minor (0.005-0.999 percent) PNH clone populations found in bone marrow failure disorders.

See Compliance Statement A: www.aruplab.com/CS
CPT Code(s): 86356 x7
Cross References: PI-Linked Antigens, RBCs, Monocytes and Granulocytes (Paroxysmal Nocturnal Hemoglobinuria Panel, RBC and WBC)