EDUCATIONAL COMMENTARY – ANTIBODY ELUTION TESTING: WHEN TO USE IT AND HOW TO DO IT CORRECTLY Learning Outcomes

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چکیده

Direct Antiglobulin Test A DAT may be ordered by a physician who suspects that the patient is experiencing immune-mediated hemolysis (i.e., an antibody is causing the destruction of the patient’s RBCs). If the sample yields a positive DAT with polyspecific antihuman globulin (AHG) reagent, the result may be due to the presence of IgG and/or complement (C3) attached to the patient’s cells. This finding should be followed by another procedure in which the patient’s RBCs are incubated with an antiserum specific for IgG and another for C3. This phase of testing may be called the “split DAT.” The most common result in autoimmune hemolytic anemia (AIHA) is a DAT positive for IgG only; next most common are cases with both IgG and C3 attached to the cells. Either result is characteristic of the warm type of AIHA. In the rarer form of AIHA, cold agglutinin disease (CAD), the autoantibody is an IgM. The DAT in CAD is positive only for C3 because the AHG reagent does not recognize IgM, and this antibody class is very efficient in activating complement and causing intravascular hemolysis.

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تاریخ انتشار 2008