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The results from this investigation indicate that the performance of antenatal titrations by column agglutination technology (CAT) is at least as good as the performance by the indirect antiglobulin test (IAT) tube method.
ABBREVIATIONS: AHG = anti-human globulin; AIHA = autoimmune hemolytic anemia; CAS = cold agglutinin syndrome; DAY = direct antiglobulin test; HDN = hemolytic disease of the newborn; IAT = indirect antiglobulin test; IHA = immune hemolytic anemia; LISS = low ionic strength solution; PAM = prophylactic antigen-matched; PCH = paroxysmal cold hemoglobinuria; PEG = polyethylene glycol; RBC = red blood cell; WAIHA = warm autoimmune hemolytic anemia.
A comparison of conventional tube test and gel technique in evaluation of direct antiglobulin test. Hematology 2007;12(2):175-8.
* A positive direct antiglobulin test (DAT) without clinically evidence of hemolysis may be found in 7-14% of patients [5].
Direct antiglobulin test was done using LISS Coombs gel card; 50 [micro]L of the red cell suspension was added to the appropriate microtube and it was centrifuged for 10 minutes.
Serological studies: The donor's red cells were tested with four FDA-licensed antisera using the immediate spin and saline indirect antiglobulin test in accordance with the manufacturers' specifications.
MAHA is defined as nonimmune hemolysis (i.e., negative direct antiglobulin test) with prominent red cell fragmentation (schistocytes) observed on the peripheral blood smear.
The result of the direct antiglobulin test (DAT) [3] was 2+ (moderately positive) for IgG, and the eluate was nonreactive.
The Coombs antiglobulin test forms the basis for diagnosis in this case.
Laboratory findings on admission to the clinic Test Result Normal Range Complete blood count Hemoglobin (g/dI) 11.7-15.0 Hematocrit (%) 28.1 35-45 Leukocyte count (xlOe9/L) 3.9 4.5-11.0 Absolute neutrophil count (xlOe9/L) Platelet count (xl 0e9/L) 87.0 150-400 Others Direct & indirect antiglobulin test Negative Serum IgG level (gIL) 19.4 7.0- 16.0 Serum 1gM level (gIL) 3.11 0.4-2.3 Serum IgA level (gIL) 3.38 0.7-4.0 Gamma globulin level in serum 23 (polyclonal) 10.5-19.5 protein electrophoresis (%) Serum immune-fixation test Negative Serum ferritin level (ng/ml) 263 11.0-306.8 Vitamin B 12 level (pg/mi) 166 166-9 70 Folic acid level (ng/ml) 3.7 1.5-16.9 Abnormal values are shown in bold text Discussion
Results showed a positive antibody screen (AS) and direct antiglobulin test (DAT) negative, consistent with prior results.