Clinically significant autoimmune hemolytic anemia with a negative direct antiglobulin test by routine tube test and positive by column agglutination method

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Immunohematology

American National Red Cross

Subject: Medical Laboratory Technology

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ISSN: 0894-203X
eISSN: 1930-3955

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VOLUME 18 , ISSUE 4 (December 2002) > List of articles

Clinically significant autoimmune hemolytic anemia with a negative direct antiglobulin test by routine tube test and positive by column agglutination method

Marco Lai / Carlo Rumi / Giuseppe D’Onofrio / Maria Teresa Voso / Giuseppe Leone

Keywords : direct antiglobulin test, column agglutination method, autoimmune hemolytic anemia, low-affinity antibodies

Citation Information : Immunohematology. Volume 18, Issue 4, Pages 109-113, DOI: https://doi.org/10.21307/immunohematology-2019-526

License : (Transfer of Copyright)

Published Online: 14-October-2020

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ABSTRACT

In two to five percent of cases of autoimmune hemolytic anemia (AIHA),the patient’s RBCs are negative in the direct antiglobulin test (DAT). We describe a patient with AIHA with a negative DAT when tested by the traditional tube test but with a strongly positive one when tested by column agglutination. When the DAT was repeated by tube test using 4°C saline washes, it became positive. This phenomenon has been observed when low-affinity antibodies are involved in AIHA. The patient’s history and serologic findings are detailed in this report.

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