PNH Confirmation Test by FLAER Method Test: Booking, Price, and Results
About PNH Confirmation Test by FLAER Method Test: Booking, Price, and Results
| Field | Value |
|---|---|
| Also Known As | PNH FLAER Test, FLAER-based PNH Assay, High Sensitivity PNH Test, PNH Flow Cytometry with FLAER |
| Sample Type | Peripheral blood (EDTA tube) and bone marrow (sodium heparin tube) |
| Fasting Required | No fasting required |
| Report Time | 1 day |
| Recommended For | Adults and children of any gender with suspected PNH or related bone marrow disorders |
| Price | Starting at ₹7,200 |
What is a PNH Confirmation Test by FLAER Method Test?
The PNH confirmation test by FLAER method test is a specialised blood and bone marrow test used to diagnose paroxysmal nocturnal haemoglobinuria (PNH), a rare condition in which red blood cells are destroyed abnormally. It uses a technique called flow cytometry alongside a fluorescent protein called FLAER to identify abnormal blood cell populations. The test is also known as the PNH FLAER test, FLAER-based PNH assay, high sensitivity PNH test, or PNH flow cytometry with FLAER. Both a peripheral blood sample and a bone marrow sample are collected for this test.
What Does a PNH Confirmation Test by FLAER Method Test Measure?
This test analyses multiple aspects of blood cell surfaces to identify cells that are missing key protective proteins. The following components are evaluated:
| Parameter | What It Represents |
|---|---|
| FLAER binding | Detects GPI anchors on cell surfaces; absent in PNH cells |
| CD14 and CD64 (monocyte markers) | Identifies GPI-deficient monocytes (a type of white blood cell) |
| CD15, CD24, CD33, and CD45 (granulocyte markers) | Identifies GPI-deficient granulocytes (another type of white blood cell) |
| CD59 and CD235a, Glycophorin A (red blood cell markers) | Detects abnormal red blood cells lacking surface protection |
Why is a PNH Confirmation Test by FLAER Method Test Done?
This test is ordered when a doctor suspects PNH or a related bone marrow disorder. It helps confirm a diagnosis and can also track disease over time.
Common Symptoms That May Require This Test
The following symptoms may prompt a doctor to order this test:
- Persistent fatigue and weakness, often linked to anaemia
- Dark-coloured urine, particularly in the morning
- Shortness of breath during routine activity
- Unusual or unexplained blood clots in veins
- Smooth muscle stiffness or spasms
- Repeated episodes of abdominal pain
- Signs of bone marrow failure such as frequent infections or unexplained bruising
Conditions This Test Can Help Detect
The PNH confirmation test by FLAER method test can help identify the following conditions:
- Paroxysmal nocturnal haemoglobinuria (PNH), where red blood cells are destroyed inside blood vessels
- Aplastic anaemia, a condition where bone marrow stops producing enough blood cells
- Myelodysplastic syndromes (MDS), a group of conditions where blood cells in the bone marrow do not develop properly
- Unexplained low blood cell counts (cytopenias)
- GPI deficiency (glucose phosphate isomerase deficiency)
PNH Confirmation Test by FLAER Method Test for Chronic Disease Monitoring
Once PNH is diagnosed, this test may be repeated periodically to track how the condition is progressing. Patients receiving complement inhibitor therapy, such as eculizumab, may have repeat testing to assess the size of the PNH clone and evaluate how well treatment is working. The frequency of repeat testing is decided by the treating haematologist based on the individual's clinical condition.
How to Prepare and What to Expect
The PNH confirmation test by FLAER method test procedure is straightforward, but a few steps will help ensure accurate results.
Do You Need to Fast?
No fasting is required before this test. You may eat and drink normally on the day of sample collection. Always follow specific instructions given by your doctor or laboratory at the time of booking.
Practical Tips Before Your Test
Here are some steps to help ensure a smooth and accurate test:
- Bring a detailed clinical history including your symptoms, previous test results, and any relevant medical records, as this is required for the test
- Inform your doctor about all medications and supplements you are currently taking, as some may affect results
- If you have received a blood transfusion in the past month, let your doctor know before the test, as this can affect red blood cell results
- Stay well hydrated before your appointment
- Avoid vigorous physical activity just before sample collection
- Wear clothing that allows easy access to the inner arm for the blood draw
Step-by-Step Procedure
The PNH confirmation test by FLAER method test procedure involves two sample types collected during the same appointment. Here is what to expect:
- Your doctor or phlebotomist will review your clinical history before beginning the collection.
- For the peripheral blood sample, the skin on your arm is cleaned with an antiseptic; a needle is then used to draw approximately 3 ml of blood into a lavender-top EDTA tube; gentle pressure is applied afterwards and the site is bandaged.
- For the bone marrow sample, a small amount of bone marrow fluid (approximately 3 ml) is collected using a needle, typically from the hip bone, under local anaesthesia, and placed in a green-top sodium heparin tube; the site is bandaged after collection.
- Both samples are labelled and stored at refrigerated temperature (2 to 8°C) to maintain cell viability.
- In the lab, samples are analysed using multiparameter flow cytometry.
Factors That Can Affect Accuracy
Several factors can influence the reliability of results:
- A red cell transfusion within one month of testing can reduce the apparent size of PNH red cell clones
- Active haemolysis (ongoing red blood cell destruction) may cause the test to underestimate PNH clone size
- Samples older than 48 hours or not stored correctly may give unreliable results
- A very low white blood cell count (below 1,000 cells per microlitre) may limit the analysis to red blood cells only
- Using the wrong sample tube or anticoagulant can affect cell viability and test performance
Understanding Your PNH Confirmation Test by FLAER Method Test Results
Results from this test require careful review by a haematologist who can interpret them in the context of your full medical history. The table below shows general reference ranges:
| Parameter | Normal Range |
|---|---|
| Type III PNH red blood cells | 0 to 6 per million cells |
| PNH granulocytes | 0 to 10 per million cells |
| PNH clone threshold for positivity | 0.01% or above |
| Erythrocytes (red blood cells) abnormal | Less than 0.01% abnormal cells |
| Granulocytes FLAER-negative | Less than 0.01% FLAER-negative cells |
In individuals without PNH, FLAER binds normally to neutrophils and monocytes, and all GPI-linked proteins such as CD14, CD16, CD24, and CD59 show normal expression.
These ranges are general guidelines. Your doctor will interpret your results based on your age, health history, and other factors. Always consult a qualified healthcare professional for personalised medical advice.
Results During Special Conditions
Certain circumstances can alter how results appear:
- Active haemolysis or a recent blood transfusion may reduce the number of detectable GPI-deficient red blood cells, potentially underestimating clone size or producing a false-negative result.
- Anaemia caused by bone marrow aplasia or abnormal red cell production may produce a positive result even without significant active haemolysis.
- Red cell transfusion within one month of testing may specifically affect the accuracy of the erythrocyte PNH clone size measurement.
How to Maintain Healthy Levels
The following general wellness steps are relevant for patients being monitored for PNH or related conditions:
- Keep up with scheduled follow-up appointments and repeat flow cytometry tests as advised by your haematologist.
- Stay well hydrated and report any new symptoms such as dark urine, unusual fatigue, or shortness of breath to your doctor promptly.
- Reduce activities that increase your risk of infection or blood clots, and follow your doctor's guidance on lifestyle adjustments.
Lupin Diagnostics PNH Confirmation Test by FLAER Method Test Price
The PNH confirmation test by FLAER method test cost at Lupin Diagnostics starts at ₹7,200. This test requires a visit to a Lupin Diagnostics centre, as home collection is not available for this test. The table below shows indicative prices across major cities:
| City | Approximate Price (₹) |
|---|---|
| BHOPAL | 7200 |
| CHENNAI | 7200 |
| HYDERABAD | 7200 |
| KOLKATA | 7200 |
| NAVI MUMBAI | 7200 |
| PUNE | 7200 |
Disclaimer: Prices are indicative and may vary by location. Please confirm the current price at the time of booking.
How to Book
Follow these steps for PNH confirmation test by FLAER method test online booking:
- Select the test on the Lupin Diagnostics website.
- Choose your city and preferred centre location.
- Visit the centre at your scheduled time for sample collection.
- Receive your report via email or WhatsApp within the stipulated turnaround time.
Frequently Asked Questions
FLAER (Fluorescently Labelled Aerolysin) is a protein that binds specifically to GPI anchors on blood cell surfaces. It is considered the gold standard for PNH diagnosis because it detects all GPI-anchored proteins with high specificity, making it far more sensitive than older testing methods. The FLAER-based PNH assay can identify abnormal cells on both neutrophils and monocytes.
No special preparation is needed. You do not need to fast before the test. However, you must bring your clinical history and inform the laboratory of any recent blood transfusions, as these can affect results.
Yes. A red blood cell transfusion within one month of testing can reduce the detectable percentage of PNH red blood cells, potentially making the clone size appear smaller than it actually is. Always inform your doctor and the laboratory about any recent transfusions.
Regular monitoring is recommended for all PNH patients. For those receiving complement inhibitor therapy, the test is typically repeated every three months to track the response to treatment and any changes in the PNH clone over time.
Yes. The high-sensitivity PNH flow cytometry with FLAER can detect PNH clones as small as 0.01% of total cells. This makes it particularly useful for identifying early or subclinical PNH in patients with aplastic anaemia or related conditions.
The peripheral blood draw is similar to any routine blood test and causes minimal discomfort. The bone marrow collection involves a local anaesthetic to reduce pain, and any discomfort is brief. The laboratory team will explain each step before proceeding.
PNH Confirmation Test by FLAER Method Test: Booking, Price, and Results
