Hematology Question 19 Instructor

Consider the blood tests used when evaluating a patient with autoimmune hemolysis. How does a DAT work? What is your differential diagnosis for a DAT + hemolytic anemia?

Direct Antiglobulin Test: Detects the presence of an antibody (IgG) or complement (C3d) bound in vivo to red blood cells in a patient’s circulation.

Coombs reagent is a monospecific immunoglobulin against IgG or C3 bound to the RBC surface. Agglutination indicates a positive test.

  • Auto Antibody
    • Warm autoimmune hemolytic anemia (positive test to IgG)
    • Cold autoimmune hemolytic anemia (positive to C3d)
    • Paroxysmal Cold Hemoglobinuria
    • Mixed
    • Drug effect
  • Allo Antibody
    • Transfused blood, IVIG
    • Stem Cell transplant
    • Hemolytic disease of the newborn
  • Hyperproteinemia
    • IVIG
    • MM/Plasma Cell dyscrasia
    • Hyperalbumineria

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