scholarly journals Warm Autoimmune Hemolytic Anemia with a Direct Antiglobulin Test Positive for C3 and Negative for IgG: A Case Study and Analytical Literature Review of Incidence and Severity

2013 ◽  
Vol 6 ◽  
pp. CCRep.S11469 ◽  
Author(s):  
Amruth R. Palla ◽  
Farhad Khimani ◽  
Michael D. Craig
Keyword(s):  
Literature Review ◽  
Hemolytic Anemia ◽  
Autoimmune Hemolytic Anemia ◽  
Interesting Case ◽  
Clinical Entity ◽  
Direct Antiglobulin Test ◽  
Complement C3 ◽  
Igg Antibodies ◽  
Antiglobulin Test

Polygenic IgG autoantibodies are implicated in majority of the cases of warm autoimmune hemolytic anemia (WAIHA). In some of these cases, complement (C3) proteins accompany the IgG antibodies. WAIHA mediated by C3 alone is relatively rare. We present an interesting case of WAIHA with a direct antiglobulin test (DAT) positive for C3 but negative for IgG in a 79-year-old woman and perform an analytical literature review of the incidence and severity of this clinical entity.

Direct antiglobulin test reactive with complement only in warm type autoimmune hemolytic anemia

2007 ◽  
Vol 0 (0) ◽  
pp. 071003000343002-???
Author(s):  
L. SHVIDEL ◽  
M. SHTALRID ◽  
A. DUEK ◽  
M. HARAN ◽  
A. BERREBI ◽  
...  
Keyword(s):  
Hemolytic Anemia ◽  
Autoimmune Hemolytic Anemia ◽  
Direct Antiglobulin Test ◽  
Antiglobulin Test

Diagnosis of Auto Immune Hemolytic Anemia by Detection of RBC-Bound IgG Antibodies, Using Flow-Cytometry

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 5159-5159
Author(s):  
Jitendra Mohan Khungar ◽  
Hara Prasad Prasad Pati ◽  
Manoranjan Mahapatra
Keyword(s):  
Flow Cytometry ◽  
Hemolytic Anemia ◽  
False Negative ◽  
Direct Antiglobulin Test ◽  
Igg Antibodies ◽  
Immune Hemolytic Anemia ◽  
Antiglobulin Test ◽  
Low Levels ◽  
Positive Direct ◽  
Card Test

Abstract Abstract 5159 Introduction: Auto Immune Hemolytic Anemia (AIHA) is one of the most common types of acquired hemolytic anaemias. Its main cause is auto antibody mediated rapid destruction of RBCs. Detection of these autoantibodies to erythrocytes is of fundamental importance for diagnosis. A number of methodologies have been tried for detection & evaluation of these autoantibodies. Demonstration of a positive Direct Antiglobulin Test (DAT) against these autoantibodies is an important serological assay in the diagnosis of auto immune hemolytic anemia (AIHA). This test is also considered as pathognomonic of immune-mediated hemolysis. This routinely used direct antiglobulin test (DAT) has the disadvantage of low sensitivity and does not detect low levels of red cell auto antibodies leading sometimes to false negative results. Flow cytometry can effectively diagnose such patients of auto immune hemolytic anemia with low levels of autoantibodies. Role of flow cytometry in the diagnosis of several non-malignant haematological disorders is being explored & present study has been conducted with the same objective. Aims & Objectives: This study was conducted with the following aims and objectives: •To assess the utility of flow-cytometry (FCM) in the diagnosis of suspected AIHA patients. •Compare the sensitivity of flow-cytometry (FCM) with Direct Antiglobulin Test (DAT) by Gel-card Test (GT). •To assess the positivity in DAT negative cases by flow-cytometry in suspected AIHA cases. Material & Methods: This was a prospective study, carried out in Haematology Deptt of All India Institute of Medical Sciences, where patients with suspected auto immune hemolytic anemia (AIHA) were studied during two years period. Blood samples of suspected patients of AIHA were tested by Gel Card Test as well as by Flow cytometry for detection of RBC bound IgG. Results: A total of 50 patients with suspected diagnosis of auto immune hemolytic anemia (AIHA) were studied by flow-cytometry as well as by Gel card test (GT) for detection of RBC bound IgG. Out of these 50 cases, 41 cases have turned out to be positive and 9 were negative by flow-cytometry. The quantification of positivity by flow-cytometry was obtained by calculating percentage fluorescence. The same 50 cases were also tested by Gel card test (GT). By Gel card test, out of 50 cases, 34 were positive & 16 were negative. Therefore, there were 7 cases which were negative for RBC bound IgG by Gel card test and these were positive by flow-cytometry. The flow cytometry figures of these cases will be shown & discussed in the presentation. Conclusions: Flow-cytometry is a reliable and sensitive method of detecting RBC-bound IgG antibodies for the diagnosis of auto immune hemolytic anemia. This can be used as a new routine diagnostic technique for auto immune hemolytic anemia. Disclosures: No relevant conflicts of interest to declare.

A Comprehensive Diagnostic Algorithm for Direct Antiglobulin Test-Negative Autoimmune Hemolytic Anemia Reveals the Relative Ratio of Three Mechanisms in a Single Laboratory

2018 ◽  
Vol 140 (1) ◽  
pp. 10-17 ◽  
Author(s):  
Toyomi Kamesaki ◽  
Eiji Kajii
Keyword(s):  
Hemolytic Anemia ◽  
Autoimmune Hemolytic Anemia ◽  
Diagnostic Algorithm ◽  
Direct Antiglobulin Test ◽  
New Classification ◽  
Antiglobulin Test ◽  
Agglutination Method ◽  
Before And After ◽  
Ig G ◽  
Single Laboratory

Background: Direct antiglobulin test (DAT)-negative warm autoimmune hemolytic anemia (AIHA) is mainly caused by three mechanisms: red blood cell (RBC)-bound immunoglobulin (Ig)G below the detection limit of routine DAT; RBC-bound IgA or IgM; or low-affinity autoantibodies. Although most cases of DAT-negative AIHA are thought to be caused by RBC-bound IgG, and combinatory serological analyses are recommended, the relative ratios of each mechanism have not been clarified. Methods: Two groups of patients with undiagnosed hemolytic anemia and negative conventional tube method-DAT (TM-DAT) were investigated using anti-IgA and anti-IgM sera, or column agglutination method-DAT (CM-DAT), respectively, in addition to radioimmunological quantitation of RBC-bound IgG. Results: Three of 73 patients with DAT-negative AIHA showed positive RBC-bound IgA and normal amounts of RBC-bound IgG. Another group of 3 patients were RBC-bound IgM-positive, but only one of these showed normal amounts of RBC-bound IgG. In another group of patients with DAT-negative AIHA, 4 of the 20 showed positive CM-DAT and negative CM-DAT after washing RBCs. Three of these patients had normal amounts of RBC-bound IgG. Five patients with positive CM-DAT both before and after washing RBCs had high amounts of RBC-bound IgG. Conclusion: Relative ratios of patients with DAT-negative AIHA resulting from RBC-bound IgG, RBC-bound IgA, RBC-bound IgM, and low-affinity IgG were estimated as 80, 4, 1 and 15%, respectively. A new classification and diagnostic algorithm for DAT-negative AIHA were proposed.

scholarly journals COVID-19-ASSOCIATED DIRECT ANTIGLOBULIN TEST-NEGATIVE WARM AUTOIMMUNE HEMOLYTIC ANEMIA

CHEST Journal ◽  
2021 ◽  
Vol 160 (4) ◽  
pp. A414
Author(s):  
Tien-Chan Hsieh ◽  
Russell Lewis ◽  
Stephanie Halene
Keyword(s):  
Hemolytic Anemia ◽  
Autoimmune Hemolytic Anemia ◽  
Direct Antiglobulin Test ◽  
Antiglobulin Test
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