Sucrose lysis test
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| Sucrose lysis test | |
|---|---|
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| Synonyms | Sucrose hemolysis test |
| Purpose | screening and diagnosis of paroxysmal nocturnal hemoglobinuria |
The sucrose lysis test is a diagnostic laboratory test used for diagnosing paroxysmal nocturnal hemoglobinuria (PNH), as well as for hypoplastic anemias and any hemolytic anemia with an unclear cause.[1] The test works by using sucrose, which creates a low ionic strength environment that allows complement to bind to red blood cells.[1] In individuals with PNH, some red blood cells are especially vulnerable to lysis caused by complement.[1] The test may also produce suspicious results in other hematologic conditions, including megaloblastic anemia and autoimmune hemolytic anemia.[1] False-negative results can occur when complement activity is absent in the serum.[1] A simpler alternative called the sugar water test also involves mixing blood with sugar and observing for hemolysis, using the same principle as the sucrose lysis test.[1]
The sucrose hemolysis test was developed in the 1960s.[2] Hartmann and Jenkins first described the test in 1966.[3][4] The test was devised as a superior screen for PNH compared to the Ham's acid hemolysis test (HT) that was developed in the 1930s.[2] For decades, these two tests were the primary methods of diagnosing PNH.[2] The test is now obsolete being replaced by more advanced methods such as flow cytometry with monoclonal antibodies CD55/CD59 that target glycosylphosphatidylinositol-anchored proteins (GPI-AP) with the addition of inactivated fluorescently labeled bacterial toxins, such as fluorescently labeled aerolysin (FLAER).[2][5] Flow cytometry is the most sensitive and useful assay currently available to screen and diagnosis PNH.[5]