The Ham test is done to diagnose paroxysmal nocturnal hemoglobinuria (PNH). The test checks whether red blood cells become more fragile when they are placed in mild acid.

Blood is typically drawn from a vein, usually from the inside of the elbow or the back of the hand. The site is cleaned with germ-killing medicine (antiseptic). The health care provider wraps an elastic band around the upper arm to apply pressure to the area and make the vein swell with blood.

Next, the health care provider gently inserts a needle into the vein. The blood collects into an airtight vial or tube attached to the needle. The elastic band is removed from your arm.

Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding.

In infants or young children, a sharp tool called a lancet may be used to puncture the skin and make it bleed. The blood collects into a small glass tube called a pipette, or onto a slide or test strip. A bandage may be placed over the area if there is any bleeding.

There is no special preparation needed for this test.

When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.

A positive test can confirm the diagnosis of PNH.

The Ham test can also be used to diagnose another rare disorder called congenital dyserythropoietic anemia.

A negative test is normal.

Abnormal results may be due to:

• Paroxysmal nocturnal hemoglobinuria
• Congenital dyserythropoietic anemia, an anemia associated with erythropoietin, the hormone that normally triggers red blood cell production

There is very little risk involved with having your blood taken. Veins and arteries vary in size from one patient to another and from one side of the body to the other. Taking blood from some people may be more difficult than from others.

Other risks associated with having blood drawn are slight but may include:

• Excessive bleeding
• Fainting or feeling light-headed
• Hematoma (blood accumulating under the skin)
• Infection (a slight risk any time the skin is broken)

Elghetany M, Banki K. Erythrocytic disorders. In: McPherson R, Pincus M, eds. Henry’s Clinical Diagnosis and Management by Laboratory Methods. 21st ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 31.

Schwartz R. Autoimmune and intravascular hemolytic anemias. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 164.