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October 9, 1967

The Autohemolysis Test

Author Affiliations

Charlottesville, Va

JAMA. 1967;202(2):155. doi:10.1001/jama.1967.03130150123038

To the Editor:—  I enjoyed the article by Dr. David Prager concerning the autohemolysis test (201: 189, 1967) and agree with him that this is a very useful test in helping to categorize various hemolytic disorders.In his type I pattern of autohemolysis he includes hereditary spherocytosis (HS), glucose-6-phosphate dehydrogenase (G6PD) deficiency, and paroxysmal nocturnal hemoglobinuria (PNH). It is true that all of these disorders may show an increase in autohemolysis which is partially corrected by glucose and adenosine triphosphate (ATP), but the pattern of each is quite different. While red cells from patients with hereditary spherocytosis usually show considerable autohemolysis after 48 hours (20% to 30%), red cells from patients with G6PD deficiency hemolize only slightly more than normal cells. PNH red cells may show as much hemolysis at 48 hours as HS cells when defibrinated blood is used (heparin inhibits the hemolysis of PNH red cells), but the