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The nitroblue tetrazolium test looks to see if certain immune system cells can change a colorless chemical called nitroblue tetrazolium (NBT) into a deep blue color.
Alternative NamesNBT test
How the test is performedBlood 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.
In the laboratory, the chemical NBT is added to a sample of white blood cells. The laboratory specialist looks at the cells under a microscope and determines if the NBT made them turn blue.
How to prepare for the testIf your child is to have this test performed, it may be helpful to explain how the test will feel, and even demonstrate on a doll. Explain the reason for the test. Knowing the "how and why" may reduce the anxiety your child feels.
How the test will feelWhen the needle is inserted to draw blood, you may feel moderate pain, or only a prick or stinging sensation. Afterward, there may be some throbbing.
Why the test is performedThis test is done to screen for chronic granulomatous disease.
Normally, white blood cells called neutrophils make special oxygen compounds that kills bacteria. In chronic granulomatous disease, these compounds are missing. These compounds causes NBT to change from clear to deep blue. If they are missing, the white blood cells will not change color when NBT is added.
Normal ValuesNormally, the white blood cells turn blue when NBT is added. This means that the cells are producing the special oxygen compounds needed to kill bacteria.
Talk to your doctor about the meaning of your specific test results.
What abnormal results meanIf the sample does not change color when NBT is added, the white blood cells are missing the substance necessary to kill bacteria. This may be due to chronic granulomatous disease.
What the risks areThere 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)
The nitroblue tetrazolium test is a diagnostic test used to assess the ability of neutrophils to convert the dye nitroblue tetrazolium into formazan in response to stimulation. It is primarily used to evaluate neutrophil function in disorders such as chronic granulomatous disease, where there is impaired production of reactive oxygen species by neutrophils. A reduced ability of neutrophils to form formazan in this test can indicate an underlying immune deficiency.
The nitroblue tetrazolium test looks to see if certain immune system cells can change a colorless chemical called nitroblue tetrazolium (NBT) into a deep blue color.
Alternative NamesNBT test
How the test is performedA blood sample is needed. For information on how this is done, see: Venipuncture
In the laboratory, the chemical NBT is added to a sample of white blood cells. The laboratory specialist looks at the cells under a microscope and determines if the NBT made them turn blue.
How to prepare for the testIf your child is to have this test performed, it may be helpful to explain how the test will feel, and even demonstrate on a doll. Explain the reason for the test. Knowing the "how and why" may reduce the anxiety your child feels.
How the test will feelWhen the needle is inserted to draw blood, you may feel moderate pain or only a prick or stinging sensation. Afterward, there may be some throbbing.
Why the test is performedThis test is done to screen for chronic granulomatous disease. This disorder is passed down in families. In people who have this disease, certain immune cells do not help protect the body from infections.
People who have frequent infections in the bones, skin, joints, lungs, and other parts of the body may have this test done.
Normal ValuesNormally, the white blood cells turn blue when NBT is added. This means that the cells should be able to kill bacteria and protect the person from infections.
Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.
What abnormal results meanIf the sample does not change color when NBT is added, the white blood cells are missing the substance needed to kill bacteria. This may be due to chronic granulomatous disease.
What the risks areThere 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)
Dinauer MC, Coates TD. Disorders of phagocyte function and number. In: Hoffman R, Benz EJ Jr, Shattil SJ, et al, eds. Hoffman Hematology: Basic Principles and Practice. 5th ed. Philadelphia, Pa: Churchill Livingstone Elsevier;2008:chap 50.
Reviewed ByReview Date: 02/20/2011
David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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