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Clinical Chemistry 17: 1028-1032, 1971;
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Clinical Chemistry, Vol 17, 1028-1032, Copyright © 1971 by the American Association for Clinical Chemistry

Dithionite Tube Test—A Rapid, Inexpensive Technique for the Detection of Hemoglobin S and Non-S Sickling Hemoglobin

Robert M. Nalbandian 1, Bruce M. Nichols 1, Frank R. Camp Jr. 1, Jeanne M. Lusher 1, Nicholas F. Conte 1, Raymond L. Henry 1, and Paul L. Wolf 1

1 Blodgett Memorial Hospital, Grand Rapids, Mich. 49506 (R.M.N., B.M.N.); U. S. Army Medical Research Laboratory, Fort Knox, Ky. 40121 (F.R.C., N.F.C.); School of Medicine, Wayne State University, Detroit, Mich. 48207 (R.M.N., J.M.L., R.L.H.); and Stanford University Medical Center, Stanford, Calif. 94305 (P.L.W.).

An inexpensive, rapid, convenient screening tube test for the detection of hemoglobin S and non-S sickling hemoglobins has been developed, which has a molecular basis. The reagents consist of potassium phosphate, sodium dithionite, and saponin. When sickling red cells are introduced into such a solution, the red cells lyse immediately, the hemoglobin deoxygenates, the beta globin chains of each hemoglobin tetramer are displaced laterally, complementarity of steric fit between interacting hemoglobin tetramers is achieved in accordance with the recently modified Murayama hypothesis for the molecular mechanism of sickling, a nematic liquid crystal system is formed, and in the presence of hemoglobin S or non-S sickling hemoglobins, the system becomes turbid. On addition of urea, those nematic liquid crystal systems dependent upon hydrophobic bonds are dispersed.


Key Words: sickle cell disease • Murayama hypothesis • molecular mechanism of sickling • nematic liquid crystal system • urea • "Sickledex" test

Submitted on June 21, 1971
Accepted on July 21, 1971






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Copyright © 1971 by the American Association for Clinical Chemistry.