Positive direct antiglobulin test: is it a risk factor for significant hyperbilirubinemia in neonates with ABO incompatibility?

2021 ◽  
Author(s):  
Secil Ercin ◽  
Yesim Coskun ◽  
Kalender Kayas ◽  
Nazan Kavas ◽  
Tugba Gursoy
Keyword(s):  
Risk Factor ◽  
Blood Group ◽  
Bilirubin Level ◽  
Newborn Infants ◽  
Direct Antiglobulin Test ◽  
Control Group ◽  
Study Group ◽  
Abo Incompatibility ◽  
Antiglobulin Test ◽  
Positive Direct

Objective: ABO incompatibility is a common cause of neonatal indirect hyperbilirubinemia. The direct antiglobulin test (DAT) can identify infants developing hemolytic disease. This study aims to evaluate the significance of DAT positivity among neonates with ABO incompatibility. Study Design: This retrospective study included 820 neonates with blood group A or B who were born to blood group O mothers. The study group consisted of neonates (n = 79) who had positive DAT, and the control group consisted of infants (n = 741) who had negative DAT. Demographic and clinical data of the neonates regarding jaundice were collected and compared statistically. Results: The bilirubin level at 24 hours of life (study group 8 ± 2.6 mg/dl, control group 6 ± 2.2 mg/dl, p < 0.001) and the highest bilirubin level (study group 12.7 ± 3.6 mg/dl, control group 10.4 ± 4.2 mg/dl, p < 0.001) were higher in infants with positive DAT. In the study group 37 (46.8%) infants and in the control group 83 (11.2%) infants received PT in the nursery (p < 0.001). In neonates with positive DAT; direct bilirubin level, duration of hospitalization, and PT in the nursery were higher (p = 0.002, p < 0.001, and p < 0.001), whereas hemoglobin level was lower (p < 0.001). Conclusion: In neonates with ABO incompatibility, a positive DAT is a risk factor for developing significant hyperbilirubinemia. Close follow-up of newborn infants with ABO incompatibility is crucial for early detection and treatment of neonatal jaundice to avoid early and late complications.

scholarly journals Risk Assessment For Readmission For Phototherapy in Neonates With ABO Hemolytic Disease

2021 ◽  
Author(s):  
Chuncai Xu ◽  
Yingying Bao ◽  
Yuanyuan He ◽  
Jingxin Zhao ◽  
Fengjuan Ji ◽  
...  
Keyword(s):  
Risk Factors ◽  
Initial Level ◽  
Laboratory Data ◽  
Direct Antiglobulin Test ◽  
Total Serum ◽  
Control Group ◽  
Hemolytic Disease ◽  
Antiglobulin Test ◽  
Abo Hemolytic Disease ◽  
Positive Direct

Abstract Background: ABO hemolytic disease of the newborn (ABO HDN) is a main risk factor for neonatal hyperbilirubinemia, which is one of the most common causes for readmission in neonates after discharge. Our objective is to assess the risk factors for readmission in neonates with ABO hemolytic disease for phototherapy.Methords: 291 neonates at gestational age ≥ 35 weeks were enrolled with the diagnosis of ABO hemolytic disease by collecting their clinical and laboratory data retrospectively. All these infants were born in Women’s Hospital School of Medicine Zhejiang University between 2018 and 2019. . Among these neonates, 36 cases were readmitted due to hyperbilirubinemia, which is defined as the study group, while the other 255 cases as the control group.Results: The study and control groups were similar on maternal and infants basic parameters (P> 0.05), as well as the complications of both infants and mothers (P> 0.05). However, we found significant differences in the concentration of initial total serum bilirubin, the onset age for phototherapy, the positive direct antiglobulin test (DAT) between two groups (P <0.05). Logistic regression analysis suggested that the age for onset phototherapy and the initial level of total serum bilirubinwere both independent risk factors for readmission in neonates with ABO hemolytic disease.Conclusions: For neonates with hyperbilirubinemia due to ABO HDN, positive direct antiglobulin test (DAT), small age for phototherapy and high initial level of bilirubin can increase the risk of readmission for phototherapy.

scholarly journals Maternal Blood Group and Routine Direct Antiglobulin Testing in Neonates: Is There a Role for Selective Neonatal Testing?

Children ◽  
2021 ◽  
Vol 8 (5) ◽  
pp. 426
Author(s):  
Hwazen A. Shash ◽  
Suzan A. Alkhater
Keyword(s):  
Retrospective Analysis ◽  
Blood Group ◽  
Maternal Blood ◽  
Control Group ◽  
Hemolytic Disease ◽  
Abo Incompatibility ◽  
Selective Approach ◽  
Antiglobulin Test ◽  
Neonatal Blood ◽  
Group B

Recommendations for the screening of hemolytic disease of the newborn (HDN) advise taking a selective approach in using the direct antiglobulin test (DAT) for mothers with blood group O or RhD-negative. This study assessed the relation of DAT results to maternal and neonatal blood groups and evaluated the risk of HDN. A retrospective analysis of all healthy newborns admitted during 2018 was performed. Of 1463 newborns, 4.4% had a positive DAT. There were 541 (37%) maternal–neonatal pairs with ABO incompatibility, most commonly born to mothers with blood group O. The cohort of neonates born to mothers with blood group O was divided into three groups: the O-A and O-B groups and the O-O group as a control. The DAT was positive in 59 (8.3%) neonates; most were in the O-B group (49.2%), whereas 13.6% were in the control group (p < 0.01). While the neonates in the O-B group were more likely to require phototherapy (p = 0.03), this finding was not related to DAT results. We found that selective testing of mothers with blood group O, mothers with blood group O or RhD-negative, neonates with blood group B, and neonates with blood group B born to mothers with blood group O or RhD-negative was ineffective in detecting phototherapy requirements. Our results indicate no difference regarding the need for phototherapy in neonates born to mothers with different blood types regardless of the DAT results.

scholarly journals Positive Direct Antiglobulin Test in COVID-19 patients: decision-making process

2021 ◽  
Author(s):  
Julien Cabo ◽  
Alice Brochier ◽  
Pascale Saussoy ◽  
Marie-Astrid van Dievoet ◽  
Lena Capirchio ◽  
...  
Keyword(s):  
Decision Making ◽  
Direct Antiglobulin Test ◽  
Decision Making Process ◽  
Antiglobulin Test ◽  
Positive Direct

Pregnancy‐associated haemolytic anaemia: A cause not to be forgotten

2021 ◽  
pp. 1753495X2110453
Author(s):  
Katherine Creeper ◽  
Dorothy Graham
Keyword(s):  
Corticosteroid Therapy ◽  
Haemolytic Anaemia ◽  
Direct Antiglobulin Test ◽  
Haemolytic Disease ◽  
Haematological Response ◽  
Antiglobulin Test ◽  
Multiparous Women ◽  
Anaemia In Pregnancy ◽  
Positive Direct ◽  
In Pregnancy

Anaemia in pregnancy is common, however, only a few cases of pregnancy-associated autoimmune haemolytic anaemia have been documented. Typically, such cases involve a positive direct antiglobulin test and have the potential to cause haemolytic disease of the fetus and newborn. Rarely, no autoantibodies are detected. We report two cases of direct antiglobulin test negative haemolytic anaemia occurring in multiparous women with no cause found. Both women had a haematological response to corticosteroid therapy and delivery.

scholarly journals Positive direct antiglobulin test in post-artesunate delayed haemolysis: more than a coincidence?

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Daniel Camprubí ◽  
Arturo Pereira ◽  
Natalia Rodriguez-Valero ◽  
Alex Almuedo ◽  
Rosauro Varo ◽  
...  
Keyword(s):  
Direct Antiglobulin Test ◽  
Antiglobulin Test ◽  
Delayed Haemolysis ◽  
Positive Direct

scholarly journals A-B Hemolytic Disease of the Newborn

Blood ◽  
1955 ◽  
Vol 10 (1) ◽  
pp. 17-28 ◽  
Author(s):  
RICHARD E. ROSENFIELD ◽  
FLORENCE EISINGER
Keyword(s):  
Reticulocyte Count ◽  
Umbilical Vein ◽  
Osmotic Fragility ◽  
Blood Groups ◽  
Direct Antiglobulin Test ◽  
Hemolytic Disease ◽  
Antiglobulin Test ◽  
Plasma Bilirubin ◽  
The Mean ◽  
Positive Direct

Abstract A study was made of oxalated umbilical vein blood of nearly every infant born at The Mount Sinai Hospital in a nine month period. A specimen of maternal blood was available for intragroup antibody screening and six cases of Rh-Hr hemolytic disease were eliminated from the data. The umbilical vein blood was tested, where possible, for: (1) group and Rh, (2) direct antiglobulin test, (3) hemoglobin, (4) reticulocyte count and examination of red cell morphology, (5) plasma bilirubin, and (6) osmotic fragility in 0.52 per cent NaCl. From the mothers’ blood groups, the infants were classified into group compatible and group incompatible, and the arithmetic means of the hemoglobin, reticulocyte count, and plasma bilirubin obtained for each class. A third class of infants, those with positive direct antiglobulin test, were analysed separately for comparison. 1. A weakly positive direct antiglobulin test was obtained on the umbilical vein blood of over 11 per cent of group incompatible infants but in none of the group compatible infants. 2. It appears that the weakly positive direct antiglobulin test detects an abnormal class of group incompatible infants, since their mean hemoglobin is low, their mean reticulocyte count is high, and their mean bilirubin is high, when these means are compared with those of the other group incompatible infants. 3. Thirty-eight of thirty-nine mothers of incompatible infants with positive direct antiglobulin test were group O. In comparison with the distribution of the blood groups of the mothers of other incompatible infants, this disproportion is of significance. 4. The mean reticulocyte count of incompatible infants with negative direct antiglobulin test is slightly (but with statistical significance) higher than the mean reticulocyte count of compatible infants. This difference was found to be associated almost entirely with group O mothers. 5. Thirty-one out of thirty-eight infants with positive direct antiglobulin test had increased osmotic fragility in hypotonic NaCl. Two of the negative cases appeared to have slight spherocytosis on blood smear.

Dynamic thiol/disulphide homeostasis metrics as a risk factor for peripheral arterial disease

Vascular ◽  
2020 ◽  
pp. 170853812094724
Author(s):  
Ufuk Turan Kursat Korkmaz ◽  
Ahmet Yuksel ◽  
Ayhan Cetinkaya ◽  
Yusuf Velioglu ◽  
Erhan Renan Ucaroglu ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Risk Factor ◽  
Peripheral Arterial Disease ◽  
Laboratory Data ◽  
Arterial Disease ◽  
Control Group ◽  
Study Group ◽  
Total Thiol ◽  
Peripheral Arterial ◽  
Study Participants

Objective To examine dynamic thiol/disulphide homeostasis metrics as a novel risk factor of oxidative stress in patients with peripheral arterial disease. Methods One hundred patients with lower extremity peripheral arterial disease (a study group) and 100 control subjects were included in this prospective case–control study. Participants’ baseline clinical characteristics and laboratory data including some oxidant/antioxidant status parameters such as albumin, ferroxidase and myeloperoxidase, and thiol/disulphide homeostasis parameters such as native thiol, total thiol and disulphide, as well as native thiol/total thiol, disulphide/native thiol and disulphide/total thiol ratios were all recorded and then compared between the groups. Results Mean albumin and ferroxidase, and median myeloperoxidase levels were found to be significantly higher in patients with the peripheral arterial disease than in control group ( p = 0.045, p = 0.000 and p = 0.000, respectively). Mean native thiol and total thiol, and median disulphide levels were found to be significantly lower in the study group as compared with the control group ( p = 0.000, p = 0.000 and p = 0.037, respectively). According to the results of logistic regression analysis, systolic blood pressure, ferroxidase and myeloperoxidase levels were detected to be the independent predictors of peripheral arterial disease. Conclusion Our report is the first one in the literature investigating dynamic thiol/disulphide homeostasis metrics as a novel risk factor of oxidative stress in peripheral arterial disease. Dynamic thiol/disulphide homeostasis metrics may be used as a valuable risk factor of oxidative stress in patients with the peripheral arterial disease since it is readily available, easily calculated and relatively cheap.

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