A sickle solubility test is requested STAT on a 45-year-old patient who is to have surgery very soon. The technologist receives the sample and immediately takes the reagent out from the refrigerator and performs the test. It comes back positive. The surgery is postponed until hemoglobin electrophoresis is performed, and it shows a normal distribution of adult hemoglobins. What is the most likely reason for the discrepant result?

Question

Quizplus · Accepted Answer

The sickle solubility test can yield a false positive result if the reagent used in the test is cold. This is because cold reagents can cause non-specific precipitation of hemoglobin, mimicking the precipitation seen with sickle hemoglobin (HbS) in individuals with sickle cell traits or disease. The discrepancy between the initial positive sickle solubility test and the normal hemoglobin electrophoresis results can be explained by this phenomenon. Hemoglobin electrophoresis is a more specific and definitive test for identifying the types of hemoglobin present and confirmed the absence of sickle cell hemoglobin, indicating that the initial test result was indeed a false positive.

A Sickle Solubility Test Is Requested STAT on a 45-Year-Old