Mass Screening for Sickle Cell Hemoglobin
Is There an Optimal Method?
- Robert M. Nalbandian, MD;
- COL Frank R. Camp Jr, MSC;
- Raymond L. Henry, PhD;
- COL Nicholas F. Conte, MC
- USA (Ret); USA
- From the Department of Pathology, Blodgett Memorial Hospital, Grand Rapids, Mich, the Department of Physiology, School of Medicine, Wayne State University, Detroit (Drs Nalbandian and Henry); the Department of Pathology, Michigan State University, East Lansing (Dr Nalbandian); the Louisville Regional Blood Center, Louisville, Ky (COL Camp); and the Office of the Surgeon General, Department of the Army, Washington, DC (COL Conte).
Abstract
The problem of screening large civilian and military populations for sickle cell hemoglobin and related conditions has been approached recently by three distinct methods. One method specifies hemoglobin electrophoresis as the initial screening technique, followed by a solubility (dithionite) test when a (nonspecific) "S band" is noted. Another method requires the use of the automated dithionite test, followed, when positive, by hemoglobin electrophoresis. A third method is a dual, automated technique for detecting anemia or hemoglobin S or both in the initial screening study; hemoglobin electrophoresis studies are done when indicated. All three methods provide data suitable for accurate diagnosis and genetic counseling, but substantial variations in costs and redundancy of data are found among these methods. Because it gives the "biggest diagnostic bang for the buck," the third merits widespread adoption.
(JAMA 234:832-835, 1975)
Footnotes
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The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense.
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Reprint requests to Department of Pathology, Blodgett Memorial Hospital, Grand Rapids, MI 49506 (Dr Nalbandian).
