Autoimmune hemolytic anemia laboratory findings: Difference between revisions
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==Laboratory Findings== | ==Laboratory Findings== | ||
*''' | A variety of laboratory tests can be used to help diagnose autoimmune hemolytic anemia. | ||
:*'''[[Coombs' test]]''': This is also known at the direct antiglobulin test. This test assesses for the presence of antibodies attached to a patient's [[red blood cells]]. The test is performed by collecting peripheral blood containing [[red blood cells]], which theoretically harbor antibodies in their surface, then adding in a Coombs' reagent and assessing for agglutination. Of note, the Coombs' test can be negative in 3-10% of patients.<ref name="pmid25705656">{{cite journal| author=Berentsen S, Sundic T| title=Red blood cell destruction in autoimmune hemolytic anemia: role of complement and potential new targets for therapy. | journal=Biomed Res Int | year= 2015 | volume= 2015 | issue= | pages= 363278 | pmid=25705656 | doi=10.1155/2015/363278 | pmc=4326213 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25705656 }} </ref> | |||
:*'''Indirect anti-globulin test''': This is also known as the indirect [[Coombs' test]]. The indirect anti-globulin test involves detection of circulating anti-[[red blood cell]] antibodies. The test involves using reagent [[red blood cell]], which are commercially available, and adding the patient's serum (which presumably contains the anti-[[red blood cell]] antibodies. Then, the Coombs's reagent is added, and agglutination is observed. | :*'''Indirect anti-globulin test''': This is also known as the indirect [[Coombs' test]]. The indirect anti-globulin test involves detection of circulating anti-[[red blood cell]] antibodies. The test involves using reagent [[red blood cell]], which are commercially available, and adding the patient's serum (which presumably contains the anti-[[red blood cell]] antibodies. Then, the Coombs's reagent is added, and agglutination is observed. | ||
:*'''[[Hemoglobin]] in the urine''': Elevated urine hemosiderin indicates intravascular hemolysis. | :*'''[[Hemoglobin]] in the urine''': Elevated urine hemosiderin indicates intravascular hemolysis. | ||
Revision as of 23:07, 31 March 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-In-Chief: Prashanth Saddala M.B.B.S; Shyam Patel [2]
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Overview
Laboratory Findings
A variety of laboratory tests can be used to help diagnose autoimmune hemolytic anemia.
- Coombs' test: This is also known at the direct antiglobulin test. This test assesses for the presence of antibodies attached to a patient's red blood cells. The test is performed by collecting peripheral blood containing red blood cells, which theoretically harbor antibodies in their surface, then adding in a Coombs' reagent and assessing for agglutination. Of note, the Coombs' test can be negative in 3-10% of patients.[1]
- Indirect anti-globulin test: This is also known as the indirect Coombs' test. The indirect anti-globulin test involves detection of circulating anti-red blood cell antibodies. The test involves using reagent red blood cell, which are commercially available, and adding the patient's serum (which presumably contains the anti-red blood cell antibodies. Then, the Coombs's reagent is added, and agglutination is observed.
- Hemoglobin in the urine: Elevated urine hemosiderin indicates intravascular hemolysis.
- Reticulocyte count: Patients with autoimmune hemolytic anemia will mount a compensatory response to red blood cell destruction by increasing erythroid production from the bone marrow. The immediate precursor to mature red bloods cells is the reticulocyte. An elevated reticulocyte count is an indication of active hemolysis.
- Serum bilirubin: Bilirubin is a breakdown product of biliverdin, which is a breakdown product of heme, which is found in hemoglobin. Upon red blood cell destruction in autoimmune hemolytic anemia, free heme is released into the circulation and is eventually broken down to bilirubin. An elevated total bilirubin and indirect (unconjugated) bilirubin is an indication of hemolysis.
- Serum haptoglobin: Bilirubin binds to haptoglobin, and therefore haptoglobin decreases in autoimmune hemolytic anemia. The level is typically less than 8 mg/dl in patients with active hemolytic anemia.
- Serum LDH: Lactate dehydrogenase (LDH) is an intracellular enzyme in red blood cells and is released upon destruction of red blood cells. Patients with autoimmune hemolytic anemia have elevated LDH (typically greater than 300 units per liter).
References
- ↑ Berentsen S, Sundic T (2015). "Red blood cell destruction in autoimmune hemolytic anemia: role of complement and potential new targets for therapy". Biomed Res Int. 2015: 363278. doi:10.1155/2015/363278. PMC 4326213. PMID 25705656.