direct antiglobulin test
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Author(s):  
Secil Ercin ◽  
Yesim Coskun ◽  
Kalender Kayas ◽  
Nazan Kavas ◽  
Tugba Gursoy

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.


2021 ◽  
pp. 1753495X2110453
Author(s):  
Katherine Creeper ◽  
Dorothy Graham

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.


2021 ◽  
Author(s):  
Chuncai Xu ◽  
Yingying Bao ◽  
Yuanyuan He ◽  
Jingxin Zhao ◽  
Fengjuan Ji ◽  
...  

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.


2021 ◽  
Author(s):  
Mahin Behzadi Fard ◽  
Ali Arianezhad ◽  
Ali Bandehzadeh

Abstract A 49-year-old woman with type 2 diabetes mellitus presented to the emergency department. Her examination showed marked pallor, exhaustion, lethargy, yellowish eyes, anorexia, nausea and vomiting. Laboratory analysis revealed: Hemoglobin (Hb) 4.8 g/dl, MCV 91fl, platelet count 233 × 106 /L, Total bilirubin 7.0 mg/dl, Glucose 316 mg/dl, hematuria and normal G6PD. Hemolytic panel was unswerving with hemolysis. IV fluids and 2 units of packed cell were transfused. Despite transfusion, during the first 4 days of hospitalization the hemolysis continued so that immune hemolysis was suspected in spite of negative coomb's test. After 3 weeks of the patient refer to the hospital, she was discharged home with stable vital signs and Hb10 g/dl. Blood transfusion along with corticosteroids, IVIG and rituximab saved the life of this patient. We concluded in cases that presented with a severe drop in hemoglobin, even if there is a negative direct antiglobulin test (DAT) pay special attention to the immune mediated hemolysis and do not be misled with a negative coomb's test.


Author(s):  
Julien Cabo ◽  
Alice Brochier ◽  
Pascale Saussoy ◽  
Marie-Astrid van Dievoet ◽  
Lena Capirchio ◽  
...  

Author(s):  
Leidy Alejandra Toro Espinosa ◽  
Patricia Jaramillo Arbeláez ◽  
Mónica Gómez ◽  
Fabio Restrepo Restrepo ◽  
John Querubín Franco

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