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. 2017 Sep 13;65(11):627–636. doi: 10.1369/0022155417730021

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© The Author(s) 2017

This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).

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Figure 2. — (A) Relationship between spectrophotometrically detected G6PD activity in RBC lysates and the percentage negative cells as determined with the cytofluorometric assay. The dashed horizontal line indicates the threshold for the percentage G6PD-negative cells in healthy controls (10.15%). The dashed vertical line indicates the lower threshold for G6PD activity (3.8 IU g/Hb) in healthy controls. Black dots represent patients without G6PD deficiency, and gray dots represent patients with heterozygous G6PD deficiency as determined by genetic analysis. Note that 4 females with normal G6PD activity and without mutations in G6PD showed a significant number of negative RBCs as measured by flow cytometry. In all these cases, the negative population appeared as a shoulder of the positive populations and should be interpreted as inconclusive. (B) Relationship between G6PD:GR ratio and the percentage negative cells as determined with the cytofluorometric assay. Additional testing for heterozygous G6PD deficiency was recommended for females with a G6PD:GR ratio between 0.46 and 0.9 (dashed vertical lines). The dashed horizontal line indicates the threshold for the percentage G6PD-negative cells in healthy controls (10.15%). Black dots represent patients without G6PD deficiency, and gray dots represent patients with G6PD deficiency as determined by the reference standard, genetic analysis. (C) Relationship between chromate-inhibited spectrophotometric determination of GR activity and the percentage negative cells as determined with cytofluorometry. The dashed horizontal line indicates the threshold for the percentage G6PD-negative cells in healthy controls (10.15%). The dashed vertical lines indicate the range from 1.7 to 2.0, which was considered to represent an inconclusive result of chromate inhibition. Chromate-inhibited activity <1.7 was considered to indicate absence of G6PD deficiency. Chromate-inhibited activity >2.0 was considered to indicate G6PD deficiency. Black dots represent patients without G6PD deficiency, and gray dots represent patients with G6PD deficiency as determined by genetic analysis. In all 4 females without a mutation in G6PD that showed a significant number of negative RBCs as measured by flow cytometry, the negative population appeared as a shoulder of the positive peak and should be interpreted as inconclusive. Abbreviations: G6PD, glucose-6-phosphate dehydrogenase; RBC, red blood cell; IU g/Hb, international units per gram hemoglobin; GR, glutathione reductase.