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Old 09-21-2011
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Default most accurate test

15 years old male, presented with episodic dark urine with the first urination of the day. CBC showed pancytopenia, iron studies showed iron deficiency. The most accurate test to confirm the diagnosis in this condition is:
  • BM examination.
  • Flow cytometry.
  • Peripheral blood smears.
  • To do LDH, indirect bilirubin & reticulocytes count.
  • Ham test & sucrose hemolysis.
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Old 09-21-2011
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PNH
Flow cytometry shows decreased level of CD55 and CD 59 ( decay accelerating factor )
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Old 09-21-2011
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flow cytometry..
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Old 09-21-2011
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Quote:
Originally Posted by ag2011n View Post
15 years old male, presented with episodic dark urine with the first urination of the day. CBC showed pancytopenia, iron studies showed iron deficiency. The most accurate test to confirm the diagnosis in this condition is:
  • BM examination.
  • Flow cytometry.
  • Peripheral blood smears.
  • To do LDH, indirect bilirubin & reticulocytes count.
  • Ham test & sucrose hemolysis.
Flow cytometry for PNH for DAF, CD 55 and CD 59.
Ham and sucrose test are valid, too, but not as "the best", flow cytometry is more accurate to confirm the diagnosis.
If it would ask for the best initial test, I would go for LDH, indirect bili and reticulocytes, to confirm the hemolytic anemia and go on from there as there are more differential diagnosis to hematuria.
Good Q!
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