BACKGROUND Laboratory testing is helpful when evaluating patients with suspected Lyme disease (LD). A 2-tiered antibody testing approach is recommended, but single-tier and nonvalidated tests are also used. We conducted a survey of large commercial laboratories in the United States to assess laboratory practices. We used these data to estimate the cost of testing and number of infections among ...

OBJECTIVES The objective of the present study was to measure and compare the direct costs of intensive care unit (ICU) days at seven ICU departments in Germany, Italy, the Netherlands, and the United Kingdom by means of a standardized costing methodology. METHODS A retrospective cost analysis of ICU patients was performed from the hospital's perspective. The standardized costing methodology w...

Although positive direct Coombs' tests occur in most patients with active systemic lupus erythematosus (SLE), haemolytic anaemic associated with antibody to erythrocytes (E) occurs in less than 10%. Our studies show an association between positive direct Coombs' tests and both the presence of circulating immune complexes and diminished activity of the C3b receptor (CR1) of E. Data presented in ...

A raised reticulocyte count is common in patients with immune or autoimmune haemolytic anaemia, and the result of the direct antiglobulin test (DAGT) is usually positive because of IgG or IgG and complement components on the red cells. We report on three patients who had low reticulocyte counts when they were most anaemic, and in whom no red cell autoantibodies could be detected by the DAGT. We...

We evaluated the validity and the usefulness of a new test for the diagnosis of human brucellosis based on an immunocapture-agglutination technique. A total of 315 sera from 82 patients with a diagnosis of brucellosis, 157 sera from patients in whom brucellosis was suspected but not confirmed, and 412 sera from people living in rural areas with endemic brucellosis were studied. The seroagglutin...

Despite the rapid development of knowledge it still remains fundamental that mistakes within the ABO and Rhesus systems are responsible for virtually all fatal mismatched transfusions. It therefore cannot be too highly stressed that the careful preliminary grouping of the bloods of all patients for transfusion is of prime importance, irrespective of whether there is a previous record of their b...

FTER THE pioneer work of the French School in the study of acquired hemolytic anemia ( Hayem,’ Chauffard,2 WidaP ) , and the demonstration of hemolysins 30 years later by Dameshek and Schwartz,4 Boorman, Dodd and Loutit5 demonstrated the presence of a positive direct antiglobulin test. Thus, the immunologic origin of some of these cases has been gradually clarified, although many aspects of the...

An isolated IgA-mediated autoimmune hemolytic anemia can present a diagnostic challenge. When a routine direct antiglobulin test (DAT) is negative but clinical suspicion remains high, further testing with monospecific antisera should be performed. As with IgG-mediated WAIHA, steroids are first-line treatment, though splenectomy is often required to achieve a durable treatment response.

A 56-year-old Chinese lady with valvular heart disease and atrial fibrillation was referred to us from a private hospital for further management of autoimmune haemolytic anaemia. Physical examination and laboratory investigations did not support the diagnosis of haemolytic anaemia. However, direct antiglobulin test (DAT) was strongly positive with anti-IgG and negative with anti-C3d. There was ...