Nitroblue tetrazolium test

Alternative names:

NBT test

How the test is performed:

Blood is drawn from a vein (venipuncture), usually from the inside of the elbow or the back of the hand. The puncture site is cleaned with antiseptic, and a tourniquet (an elastic band) or blood pressure cuff is placed around the upper arm to apply pressure and restrict blood flow through the vein. This causes veins below the tourniquet to distend (fill with blood). A needle is inserted into the vein, and the blood is collected in an air-tight vial or a syringe. During the procedure, the tourniquet is removed to restore circulation. Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding.

In the laboratory, NBT is added to the sample and observed for color change. The neutrophils (a type of cell in your immune system that kill bacteria by ingesting them) normally release a chemical after ingesting bacteria that kills them. In chronic granulomatous disease (CGD), this chemical is absent. As a result, neutrophils are able to ingest bacteria, but not kill them. The chemical that kills the bacteria is the same that turns NBT from a clear to a deep blue. If the chemical is absent when NBT is added to the sample, it will not change color.

How to prepare for the test:

If your child is to have this test performed it may be helpful to explain how the test will feel, and even practice or demonstrate on a doll. The more familiar your child is with what will happen to them, and the purpose for the procedure, the less anxiety they will feel.

How the test will feel:

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.

Why the test is performed:

This test is performed as a screen for (CGD).