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## Reticulocyte Preparation (brilliant cresyl blue stain) - Usually elevated, less than expected for the degree of anemia. - Prolonged incubation with brilliant cresyl blue stain causes Hb H to precipitate. - Results in characteristic appearance of multiple discrete inclusions - golf ball appeara...
## Reticulocyte Preparation (brilliant cresyl blue stain) - Usually elevated, less than expected for the degree of anemia. - Prolonged incubation with brilliant cresyl blue stain causes Hb H to precipitate. - Results in characteristic appearance of multiple discrete inclusions - golf ball appearance of RBCs (inclusions smaller than Heinzbodies and are evenly distributed throughout cell). Positive in Hb H disease and Hb Bart's hydrops fetalis ## Acid Elution Stain - Based on the Kleihauer-Betke procedure. Acid pH will dissolve Hb A from red cells. - Hb F is resistant to denaturation and remains in cells. Stain slide with eosin. Normal adult cells appear as "ghost" cells while cells with Hb F stain varying shades of pink. - Useful way to differentiate HPFH from beta thalassemia ## Hemoglobin Electrophoresis and or HPLC - Important role in diagnosing and differentiating various forms of thalassemia. - Separates the normal Hbs (Hb A, Hb A2 , and Hb F) as well as the Hbvariants (such as Hemoglobin Lepore, hemoglobin Bart's, Hb H or Hemoglobin C) - Also aids in detecting combinations of thalassemia and hemoglobinopathies.
