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The direct antiglobulin test: A critical step in the evaluation of hemolysis
Author(s) -
Zantek Nicole D.,
Koepsell Scott A.,
Tharp Daryl R.,
Cohn Claudia S.
Publication year - 2012
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.23218
Subject(s) - hemolysis , hemolytic anemia , coombs test , medicine , immunology , autoimmune hemolytic anemia , hemolytic disease of the newborn (abo) , agglutination (biology) , red cell , red blood cell , etiology , anemia , antibody , fetus , pregnancy , biology , genetics
The direct antiglobulin test (DAT) is a laboratory test that detects immunoglobulin and/or complement on the surface of red blood cells. The utility of the DAT is to sort hemolysis into an immune or nonimmune etiology. As with all tests, DAT results must be viewed in light of clinical and other laboratory data. This review highlights the most common clinical situations where the DAT can help classify causes of hemolysis, including autoimmune hemolytic anemia, transfusion‐related hemolysis, hemolytic disease of the fetus/newborn, drug‐induced hemolytic anemia, passenger lymphocyte syndrome, and DAT‐negative hemolytic anemia. In addition, the pitfalls and limitations of the test are addressed. False reactions may occur with improper technique, including improper washing, centrifugation, and specimen agitation at the time of result interpretation. Patient factors, such as spontaneous red blood cell agglutination, may also contribute to false results. Am. J. Hematol. 87:707–709, 2012. © 2012 Wiley Periodicals, Inc.