The EMA binding test uses flow cytometry to determine the amount of fluorescence (reflecting EMA bound to specific transmembrane proteins) derived from individual red cells. Red blood cells (RBCs) are incubated with EMA dye, which covalently binds to band 3 and other proteins on RBC surface. The mean fluorescence of EMA-stained RBCs in patients with hereditary spherocytosis is lower when compared with control RBCs due to the decreased amount of target proteins. The EMA binding test is easy to use, and test results are available for reporting in 2–3 h.
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