What is the role of a dihydrorhodamine (DHR) test in the workup of pediatric chronic granulomatous disease (CGD)?

Updated: Aug 07, 2019
  • Author: Lawrence C Wolfe, MD; Chief Editor: Cameron K Tebbi, MD  more...
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Answer

Dihydrorhodamine (DHR) test

This flow cytometric test is now widely and commercially available and should be considered the preferred screening and diagnostic test for chronic granulomatous disease. This test should be considered the most accurate diagnostic test for chronic granulomatous disease.

Phagocytic cells reduce DHR to the strongly fluorescent compound rhodamine. Individual fluorescent cells can then be counted, and the amount of fluorescence per cell is quantified with flow cytometry.

This test combines the best features of the slide and tube NBT tests, although a specialized instrument is required.

Deficiencies of gp91 (no activity, no DHR conversion) and p47 (low activity, minimal DHR conversion) can be distinguished with this method. X-linked carriers of chronic granulomatous disease can also be identified with the DHR test.


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