Diagnosis and classification of direct antiglobulin test-negative autoimmune hemolytic anemia
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- KAMESAKI Toyomi
- Center for Community Medicine, Jichi Medical University
Bibliographic Information
- Other Title
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- クームス陰性自己免疫性溶血性貧血の診断と分類
- クームス インセイ ジコ メンエキセイ ヨウケツセイ ヒンケツ ノ シンダン ト ブンルイ
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Abstract
<p>About 5-10% of patients with autoimmune hemolytic anemia (AIHA) and a negative result on the direct antiglobulin test (DAT) are difficult to diagnose. Most of these patients with AIHA have red blood cell-associated IgG levels below the cut-off value of DAT. Comprehensive diagnosis and classification of DAT-negative AIHA can be made with additional tests of low-affinity IgG and IgA/IgM autoantibodies. However, 17% of patients with DAT-negative AIHA show negative results on all these tests and are diagnosed with “clinically diagnosed DAT-negative AIHA,” after excluding other hemolytic anemias and responsiveness to steroids. This percentage can be reduced to 4% if tests are conducted during pretreatment stage. Patients with “clinically diagnosed DAT-negative AIHA” show relatively worse prognosis than patients with low-affinity IgG, and tend to receive treatment in the later stages of the disease. When treating a patient with DAT-negative hemolysis, DAT-negative AIHA should be considered and tested in reference laboratories, especially at pretreatment stage.</p>
Journal
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- Rinsho Ketsueki
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Rinsho Ketsueki 62 (5), 456-462, 2021
The Japanese Society of Hematology
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Details 詳細情報について
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- CRID
- 1390569767952660992
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- NII Article ID
- 130008049774
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- NII Book ID
- AN00252940
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- ISSN
- 18820824
- 04851439
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- NDL BIB ID
- 031539282
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- PubMed
- 34108329
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- Text Lang
- ja
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- Data Source
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- JaLC
- NDL
- PubMed
- CiNii Articles
- KAKEN
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- Abstract License Flag
- Disallowed