The enhanced direct antiglobulin test in current practice has a limited impact on management of adult patients.
Transfus Apher Sci
; 62(5): 103768, 2023 Oct.
Article
in En
| MEDLINE
| ID: mdl-37599155
ABSTRACT
INTRODUCTION:
The direct antiglobulin test (DAT) identifies immunoglobulin IgG and/or complement onthe red blood cell surface, allowing discrimination between immune and non-immunehemolysis. When the DAT is negative but there is clinical suspicion for immunehemolysis, an enhanced DAT can be sent to an immunohematology referencelaboratory (IRL).METHODOLOGY:
This retrospective study assessed the volume of enhanced DATs at a large tertiarycare center and evaluated their impact on patient care. Enhanced DATs were sent on21 adult patients (January 2019 - January 2021) at the University of Pittsburgh MedicalCenter and Allegheny Health Network. Laboratory and clinical data were collected andanalyzed.RESULTS:
Four out of 21 patients had positive tests (DAT and other serologic tests) at the localIRL. Enhanced DAT testing yielded positive results in an additional 5 patients butnegative or invalid results for 2 patients. High-dose steroid therapy was started in 12patients prior to receipt of enhanced DAT results. Enhanced DAT testing was sent amedian of 5 days after initiation of steroid therapy. For the patients trialed on steroids,the enhanced DAT results impacted medical decision-making in only 3 patients, and inonly one of those patients was the enhanced DAT positive despite a negative DAT at alocal IRL. In the non-steroid treated patients, enhanced DAT results did not contributeto clinical decision-making.CONCLUSION:
Enhanced DATs generally did not impact medical decision-making in adults withhemolytic anemia.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Alzheimer Disease
/
Anemia, Hemolytic, Autoimmune
Type of study:
Observational_studies
/
Prognostic_studies
Limits:
Adult
/
Humans
Language:
En
Journal:
Transfus Apher Sci
Journal subject:
HEMATOLOGIA
Year:
2023
Document type:
Article
Affiliation country:
Estados Unidos