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June 3, 1974

Sickle Cell Screening

Author Affiliations

Grand Rapids, Mich
Fort Knox, Ky
Wayne State University Detroit

JAMA. 1974;228(10):1227. doi:10.1001/jama.1974.03230350017007

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To the Editor.—  We are gratified that Uddin et al (227:1405, 1974) have found the automated dithionite test (Clin Chem 17:1033, 1971) so reliable in sickle cell hemoglobin screening.Because of the closing caveat about screening civilian populations, emphasis on several points is offered.The use of the automated dithionite test (ADT) as the initial method of screening, and the reservation of hemoglobin electrophoresis (HE) for those cases that are ADT-positive or that require genetic counseling, is an eminently satisfactory procedure, yielding requisite data at lowest cost.Not all newly found cases of hemoglobin S will require or demand genetic counseling; when the ADT gives positive findings, the HE should be performed on such specimens in that sequence to get the essential data. Electrophoresis does not need to be done on all specimens in any given test population.Exaggerated preoccupation with hemoglobin C has led to the expensive and redundant