Hemolytic Anemia Evaluation
Order Code: HEMOANEM
Epic Lab Code: LAB4587
Order Form: A-1a Miscellaneous Request or Epic Req
Commercial Mail-out Laboratory
6240 RCP
356-3527
Specimen:
EDTA and ACD Whole Blood
Collection Medium:
and and plus control
Lavender top tube 4 mL (EDTA) Lavender top tube 4 mL (EDTA) Yellow top tube (ACD solution A) Lavender top tube 4 mL (EDTA)
Minimum:
Draw blood in TWO 4 mL lavender-top (EDTA) tube(s) and ONE 8.5 mL yellow-top (ACD [solution A]) tube.

Absolute Minimum: 3 mL EDTA and 5 mL ACD
Rejection Criteria:
Specimens cannot be frozen
Delivery Instructions:
Submit specimen to laboratory as soon as possible after collection. Specimen must be received at reference laboratory within 96 hours of draw.
Specimen Instructions:
Include a control specimen drawn at the same time from a normal, unrelated individual: draw blood in a lavender-top (EDTA) tube(s), and send 4.0 mL of fresh EDTA whole blood refrigerated. Do not transfer blood to other containers. Label clearly on outermost label "Normal Control". Indicate sex of control on tube(s) label. Send well-made peripheral blood smear, Wright stained or fixed in absolute methanol.
Analytic Time:
3-25 days upon receipt at reference laboratory
Reference Range:
Definitive results and an interpretive report will be provided. A hematopathologist expert in these disorders evaluates the case, appropriate tests are run, and an interpretive report is issued.
Interpretive Data:
An interpretive report will be provided.
Comments:
Patient's age and sex are required on request form for processing.

Include recent transfusion information.

Please print, complete and submit the Thalassemia/Hemoglobinopathy Information Sheet and the Informed Consent for Genetic Testing from the Mayo Medical Laboratories with the specimen and the A-1a Miscellaneous Request.

Hemolytic anemia (HA) is characterized by increased red cell destruction and a decreased red cell life span. Patients have decreased hemoglobin concentration, hematocrit, and red blood cell count. Blood smear abnormalities may include spherocytes, acanthocytes, schistocytes, stomatocytes, polychromasia, and target cells. Osmotic fragility also is increased due to the presence of spherocytes.

HAs may be congenital or acquired. Inherited hemolytic disorders may include red cell membrane fragmentation, red cell enzyme defects, or abnormal structure of the hemoglobin molecule in the red cell. Examples of congenital HA include spherocytic HA and glucose-6-phosphate dehydrogenase (G-6-PD) deficiency, which may be intermittent, often brought on by certain drugs, fava bean ingestion, or infections. Some hemoglobinopathies also may demonstrate a hemolytic process. Examples of acquired HA include: autoimmune HA, direct Coombs-positive HA, disseminated intravascular coagulation, and drug-induced HA.

This consultative evaluation looks for the cause of increased red cell destruction and includes testing for hereditary spherocytosis, hemoglobinopathies, and red cell metabolism abnormalities.
Methodology:
Refer to CPT code information below.
CPT Code:
Hemolytic Anemia Evaluation 82657-RBC enzymes 82955-G-6-PD 83020-Hemoglobin electrophoresis 83021-Hemoglobin A2 and F 83068-Hemoglobin stability 84087-Glucose phosphate isomerase 84220-Pyruvate kinase 85060-Morphology review 85557-Osmotic fragility Reflexed RBC Enzymes 82664-Isoelectric focusing (if appropriate) Glutathione, Blood 82978 (if appropriate) Hemoglobin Variant by Mass Spectrometry (MS), Blood 83789 (if appropriate) Hemoglobin Electrophoresis, Molecular 83891-Isolation or extraction of highly purified nucleic acid (if appropriate) 83898 x 4-Amplification, target, each nucleic acid sequence (if appropriate) 83900-Amplification, target, multiplex, first 2 nucleic acid sequences (if appropriate) 83904 x 12-Mutation identification by sequencing, single segment, each segment (if appropriate) 83909 x 13-Separation and identification by high-resolution technique (if appropriate) 83914 x 8-Mutation identification by enzymatic ligation or primer extension, single segment, each segment (if appropriate) Hemoglobin S, Screen, Blood 85660 (if appropriate) Hemoglobin F, Red Cell Distribution, Blood 88184 (if appropriate) Band 3 Fluorescence Staining, RBC 88184 (if appropriate)