RBC Band 3 Protein Reduction in Hereditary Spherocytosis
Ordering Recommendation

Use to confirm diagnosis of hereditary spherocytosis when hemolytic anemia and spherocytes are present.

Qualitative Flow Cytometry
1-3 days
New York DOH Approval Status
This test is New York DOH approved.
Submit With Order
ARUP Consult®
Disease Topics
Specimen Required
Patient Preparation
Lavender (EDTA) or green (sodium or lithium heparin). Include a Wright stained slide. 
Specimen Preparation
Transport 4 mL whole blood in the original container. (Min: 0.5 mL) 
Storage/Transport Temperature
Unacceptable Conditions
Clotted or hemolyzed specimens. Specimens older than 7 days. 
Specimens must be analyzed within 7 days of collection. 
Ambient: 3 days; Refrigerated: 7 days; Frozen: Unacceptable 
Reference Interval
Interpretive Data
This test can be used to confirm a suspected diagnosis of Hereditary Spherocytosis (HS). HS is a common inherited hemolytic anemia characterized by the presence of spherical erythrocytes (spherocytes). HS is diagnosed based on family history and clinical features, along with clinical laboratory tests, including peripheral smear examination, osmotic fragility (OF), flow cytometry, or by genetic testing (Hereditary Hemolytic Anemia Panel Sequencing. ARUP test code 2012052).

Band 3 (or solute carrier family 4 member 1, SLC4A1) is the most abundant transmembrane protein found in human red blood cells (RBC). Eosin-5-maleimide (EMA) dye binds to band 3 on intact RBC's. A reduction of fluorescence intensity will be seen in hereditary spherocytosis. This test by flow cytometry has been reported to have a sensitivity of 93 percent for a diagnosis of HS. Congenital Dyserythropoietic Anemia Type II, Southeast Asian Ovalocytosis and Hereditary Pyropoikilocytosis are rare disorders that may also show a positive result.

Compliance Statement B: For laboratory developed tests not using a RUO kit, and for FDA approved, cleared or 510(k) exempt assays with alterations. This test was developed and its performance characteristics determined by ARUP Laboratories. The U. S. Food and Drug Administration has not approved or cleared this test; however, FDA clearance or approval is not currently required for clinical use. The results are not intended to be used as the sole means for clinical diagnosis or patient management decisions.

Hotline History
Component Test Code*Component Chart NameLOINC
2008461RBC Band 3 Protein Reduction in HS
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  • Hereditary Spherocytosis, EMA, BAND 3, Osmotic Fragility
  • HS hemolytic anema assay