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HelpTest Code DHR Dihydrorhodamine Flow Cytometric Test, Blood
Useful For
Evaluation of chronic granulomatous disease (CGD), X-linked and autosomal recessive forms, RAC2 deficiency, complete myeloperoxidase deficiency
Monitoring chimerism and nicotinamide adenine dinucleotide phosphate (NADPH) oxidase function post-hematopoietic cell transplantation
Assessing residual NADPH oxidase activity pretransplant
Identifying female carriers for X-linked CGD
Assessing changes in lyonization with age in female carriers
Reporting Name
DHR Flow, BSpecimen Type
WB Sodium HeparinShipping Instructions
Testing is performed Monday through Friday. Specimens not received by 4 p.m. Central time on Friday may be canceled. Collect and package specimen as close to shipping time as possible. Ship specimen overnight in an Ambient Shipping Box-Critical Specimens Only (T668) following the instructions in the box.
Collect and package specimen as close to shipping time as possible. Ship specimen overnight in an Ambient Shipping Box-Critical Specimens Only (T668) following the instructions in the box.
It is recommended that specimens arrive within 24 hours of collection.
Specimens arriving on the weekend and observed holidays may be canceled.
Necessary Information
Ordering healthcare professional name and phone number are required.
Specimen Required
Two whole-blood sodium heparin specimens are required, one from the testing patient and the other from an unrelated healthy donor as a control.
Supplies: Ambient Shipping Box-Critical Specimens Only (T668)
Patient:
Container/Tube: Green top (sodium heparin)
Specimen Volume: 5 mL
Collection Instructions: Send whole blood specimen in original tube. Do not aliquot.
Normal Control:
Container/Tube: Green top (sodium heparin)
Specimen Volume: 5 mL
Collection Instructions:
1. Collect a control specimen from the unrelated healthy donor within an hour of the patient's specimen collection time.
2. Label clearly with Normal Control and the corresponding patient information.
3. Send the whole blood specimen in the original tube. Do not aliquot.
Specimen Minimum Volume
1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| WB Sodium Heparin | Ambient | 48 hours | GREEN TOP/HEP |
Reject Due To
| Gross hemolysis | Reject |
| Gross lipemia | Reject |
Reference Values
|
Result name |
Unit |
Cutoff for defining normal |
|
% PMA ox-DHR+ |
% |
≥95% |
|
MFI PMA ox-DHR+ |
MFI |
≥60 |
|
% fMLP ox-DHR+ |
% |
≥10% |
|
MFI fMLP ox-DHR+ |
MFI |
≥2 |
|
Control % PMA ox-DHR+ |
% |
≥95% |
|
Control MFI PMA ox-DHR+ |
MFI |
≥60 |
|
Control % fMLP ox-DHR+ |
% |
≥10% |
|
Control MFI fMLP ox-DHR+ |
MFI |
≥2 |
PMA = phorbol myristate acetate
DHR = dihydrorhodamine
MFI = mean fluorescence intensity
fMLP = N-formyl-methionyl-leucyl-phenylalanine
The appropriate age-related reference values for Absolute Neutrophil Count will be provided on the report.
Supportive Data
Dihydrorhodamine analysis was performed to assess neutrophil oxidative burst in 157 healthy donors, 74 children and 83 adults.
Day(s) Performed
Monday through Friday
Report Available
3 to 4 daysSpecimen Retention Time
4 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
CPT Code Information
86352 x2
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| DHR | DHR Flow, B | 98122-5 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| ANC | Absolute Neutrophil Count | 751-8 |
| PMAP | % PMA ox-DHR+ | 85376-2 |
| PMAM | MFI PMA ox-DHR+ | 85374-7 |
| FMPPP | % FMLP ox-DHR+ | 85373-9 |
| FMPM | MFI fMLP ox-DHR+ | 85370-5 |
| ANCC | Control Absolute Neutrophil Count | 85369-7 |
| PMAPC | Control % PMA ox-DHR+ | 85377-0 |
| PMAMC | Control MFI PMA ox-DHR+ | 85375-4 |
| FMPPC | Control % fMLP ox-DHR+ | 85372-1 |
| FMPMC | Control MFI fMLP ox-DHR+ | 85371-3 |
| DHRI | Interpretation | 69052-9 |
Genetics Test Information
Approximately 70% of chronic granulomatous disease cases are X-linked and are due to disease-causing variants in the CYBB gene, encoding the gp91phox protein. The following genes may have genetic variants inherited in an autosomal recessive pattern: NCF1 (p47phox), NCF2 (p67phox), CYBA (p22phox), and NCF4 (p40phox). Disease-causing variants in NCF1 account for 25% of cases, while variants in NCF2 and CYBA account for 5% of cases each. Disease-causing variants in the NCF4 and CYBC1 genes have been described but are rare.