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The page below is a sample from the LabCE course Hemoglobinopathies: Hemoglobin S Disorders. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Solubility Test Errors

False-positive results using the solubility test may be obtained in persons with increased RBC counts as occur in polycythemias; extremely high white counts, as in some leukemias; and extremely high platelet counts. Increased levels of lipids or globulins may also cause a false-positive.
Hemoglobins that show a positive solubility test include Hb C-Harlem, Hb C-Georgetown, and Hb C-Ziquinchor.

False-negatives in the solubility test may be obtained on persons with severely-decreased hemoglobins/hematocrits and those recently transfused. Infants less than six months old may also demonstrate false-negative results due to higher levels of Hb F.

False results in the solubility test can occur due to technical errors. False-positive results will occur if too much blood is added to the tube. False-negative results will occur if any of these errors are made:
  • Too little blood added
  • Use of wrong-sized test tube
  • Using deteriorated reagents
  • Holding the test tube too close to the background when reading result