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Order Code PLINK Paroxysmal Nocturnal Hemoglobinuria, PI-Linked Antigen, Blood

Reporting Name

PNH, PI-Linked AG, B

Useful For

Screening for and confirming the diagnosis of paroxysmal nocturnal hemoglobinuria (PNH)

 

Monitoring patients with PNH

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Whole blood


Specimen Required


Specimen must arrive within 3 days of collection.

 

Container/Tube:

Preferred: Yellow top (ACD solution A or B)

Acceptable: Lavender top (EDTA)

Specimen Volume: 2.6 mL

Collection Instructions: Send whole blood specimen in original tube. Do not aliquot.


Specimen Minimum Volume

1 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Whole blood Ambient (preferred) 72 hours
  Refrigerated  72 hours

Reference Values

An interpretive report will be provided. 

 

RED BLOOD CELLS:

PNH RBC-Partial Antigen loss: 0.00-0.99%

PNH RBC-Complete Antigen loss: 0.00-0.01%

PNH Granulocytes: 0.00-0.01%

PNH Monocytes: 0.00-0.05%

Day(s) Performed

Monday through Saturday

CPT Code Information

88184-Flow cytometry, RBC x 1

88184-Flow cytometry, WBC x 1

88185-Flow cytometry, additional marker (each), RBC x 1

88185-Flow cytometry, additional marker (each), WBC x 6

88188-Flow Cytometry Interpretation, 9-15 Markers x 1

Method Description

Flow cytometric immunophenotyping of peripheral blood (white blood cells [WBC] and red blood cells [RBC]) is performed using the following antibodies:

 

RBC: CD235a, CD59 

WBC: CD14, CD15, CD16, CD24, CD33, CD45, and FLAER

 

This assay evaluates the presence or absence of glycosylphosphatidylinositol (GPI)-linked proteins using monoclonal antibodies directed against CD235, CD33, and CD15 to isolate different cell lineages. GPI-linked proteins that are checked within different lineages include CD14 for monocytes, CD's 16 and 24 for granulocytes, and CD59 for RBC. Fluorescent aerolysin, a fluorescently labeled inactive variant of the protein aerolysin, binds selectively to GPI anchors and is evaluated for presence or absence of expression on WBC. In addition, this test will detect a partial loss of CD59 on RBC (type II RBC).

 

Individuals without paroxysmal nocturnal hemoglobinuria have normal expression of all GPI-linked antigens on peripheral blood and leukocytes and erythrocytes.(Devalet B, Mullier F, Chatelain B, Dogne JM, Chatelain C. Pathophysiology, diagnosis, and treatment of paroxysmal nocturnal hemoglobinuria: a review. Eur J Haematol. 2015;95(3):190-198. doi:10.1111/ejh.12543)

Reject Due To

Gross hemolysis Reject
Fully Clotted Reject

Method Name

Immunophenotyping

Additional Tests

Test ID Reporting Name Available Separately Always Performed
FCIMS Flow Cytometry Interp, 9-15 Markers No, (Bill Only) Yes

Forms

If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:

-Hematopathology/Cytogenetics Test Request Form (T726)

-Benign Hematology Test Request Form (T755)