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PubMed1991

[ABO materno-fetal incompatibility in the newborn infant: clinical usefulness of Coombs test and elution for the study of hemolytic disease].

A decision to establish early treatment for hemolytic disease in the newborn is usually based upon results of the Coombs test. In order to evaluate a possible advantage of using the Elution test to help in the diagnosis of the hemolytic state, samples of cord blood from 197 consecutive newborns with ABO incompatibility were studied. Hemolysis occurred in 41. Each test (Coombs and Elution) was positive in 26 patients, for a total of 35 positive results and a combined sensitivity of 85%. False positives occurred in 24 of 156 patients with Coombs test and in 30 for the Elution test. Thus, combined results of both test would have suggested a need for phototherapy in 72 of 197 patients when in fact it was needed for only 41. Conversely, 13 patients with hemolytic disease were missed by both tests. The negative predictive value of both tests combined was 95% which is useful for clinical practice.

Coombs Test↗
PubMed1966

Viral plasmacytosis (Aleutian disease) in mink. VI. The development of positive Coombs test in experimental infections.

Coombs tests became positive coincident with the development of plasmacytosis in experimentally infected mink. These observations are discussed as possible evidence of an auto-immune phenomenon. Several mechanisms are suggested in which a virus as primary etiologic agent might promote the observed plasmacytosis, hypergammaglobulinemia, and erythrocyte sensitization.

Animals↗
PubMed2005

[Case of thrombotic thrombocytopenic purpura with a positive Coomb test].

We report a case of thrombotic thrombocytopenic purpura (TTP) with a positive Coombs' test. A 59-year-old female was admitted to our hospital in February, 1997 with symptoms of heart failure. Ultrasound cardiography showed moderate pericardiac effusion and she was diagnosed as having pericarditis. After admission she had anorexia and her urine volume was reduced. Laboratory tests showed anemia and thrombocytopenia. Her Coombs' test result was positive. Her renal function gradually worsened and her conscious level was reduced. We diagnosed her as TTP and judged that she needed hemodialysis. We performed plasma exchange and started steroid therapy. The renal biopsy was compatible with TTP. After treatment, her level of consciousness improved, but her renal function did not improve. On the 51st hospital day she fell into acute respiratory distress syndrome (ARDS) and entered ICU. We considered ARDS caused by infection and continued treatment, but she died of shock and lactate acidosis. Activity of von Willebrand factor-cleaving protease in our case was 15% before the first PE, and 25 % just before death. A case of TTP without collagen disease usually shows a negative Coombs' test result. We think that this was a rare case in which autoimmune hemolytic anemia was supervened with TTP.

Acidosis, Lactic↗
PubMed1980

Positive Coombs test in Hodgkin's disease: significance and implications.

To clarify the clinicopathologic characteristics of Coombs' positivity in Hodgkin's disease, the records of 71 cases were reviewed. The direct Coombs test was positive in seven. Mean age of the seven was 22 yr (range 11-33). All were males. All had extensive disease (pathologic stage III or IV) and six had systemic (B) symptoms. Four had mixed cellularity; three had nodular sclerosis. The positive Coombs test was detected at original diagnosis in three and at time of relapse in four. Although all were anemic, only three had evidence of overt hemolysis. The antibody responsible for Coombs positivity was characterized in three and fulfilled the criteria for IgG anti-It. The presence of a positive direct Coombs test in the patient with Hodgkin's disease suggests active and advanced disease. The presence of IgG anti-It may represent a unique antibody in the Coombs-positive hemolytic anemia associated with Hodgkin's disease.

Adolescent↗
PubMed1979

The influence of ionic strength, albumin and incubation time on the sensitivity of the indirect Coombs' test.

The sensitivity of the indirect Coombs' test was investigated using saline, albumin, or low ionic strength (LIS) in the incubation phase and an incubation time varying from 5 to 120 min. Titration of 41 antibodies showed that LIS always resulted in a higher or almost the same mean scores as the other solutions after the same incubation time. The maximum mean score was always higher with LIS than with saline and was reached after a shorter period of incubation, only 20--40 min even with the weakest antibodies. With LIS, a longer incubation time than 40 min resulted in a sudden decrease in mean score. The maximum mean score using saline or albumin was reached after 40--60 min incubation. The same mean score was obtained after only 15--20 min, when LIS was used. Albumin gave only slightly higher mean scores than saline.

Antibodies↗
PubMed1997

Autoimmune hemolytic anemia and positive Coombs test associated with ulcerative colitis.

OBJECTIVES: To estimate the frequency of autoimmune hemolytic anemia and Coombs positivity without overt hemolysis in ulcerative colitis, to determine possible subsets of patients with ulcerative colitis susceptible to this complication, and to assess the efficacy of the applied therapeutic modalities. METHODS: Three hundred and two patients with ulcerative colitis treated at the University Hospital of Heraklion, Crete, over a 6-yr period were included. Within this group, a subgroup of 152 patients were studied prospectively for the presence of a positive direct Coombs test. RESULTS: Autoimmune hemolytic anemia was diagnosed in five of 302 patients with ulcerative colitis (1.7%). One more patient developed Coombs-positive hemolytic anemia, attributed to sulfasalazine. A positive Coombs test without evidence of hemolysis was found in three of 152 patients (2%). The mean age of all Coombs-positive patients was 50.5 yr, and there was a definitive male preponderance (male: female, 2:1). Autoimmune hemolytic anemia occurred during active colitis in all cases. The mean time between the onset of colitis and the diagnosis of autoimmune hemolytic anemia was 17 months. Three of five patients with autoimmune hemolytic anemia (60%) and seven of nine of all Coombs-positive patients (77.7%) had total colitis. All patients with autoimmune hemolytic anemia were treated initially with large doses of corticosteroids. Three of five (60%) had good hematological responses. One patient responded to the addition of azathioprine, and one underwent splenectomy and proctocolectomy. CONCLUSIONS: In this study, the frequency with which autoimmune hemolytic anemia was associated with ulcerative colitis was higher than in previous reports. The complication occurred early in the course of colitis and was related to activity and extent of the disease. In contrast to others studies, we found a preponderance of males. Although corticosteroids and/or immunosuppressive therapy was successful in most of our cases, one patient required surgery.

Adolescent↗
PubMed2005

The Coombs' test in veterinary medicine: past, present, future.

The Coombs' test, also known as the antiglobulin test, is used most frequently in veterinary medicine as an aid in the diagnosis of immune-mediated hemolytic anemia. The test also is used widely in human medicine to screen for red blood cell alloantibodies. Polyspecific reagents for veterinary use typically contain anti-IgG, anti-IgM, and anti-C3. Monospecific reagents also are available. False-positive and false-negative test results can be obtained. Inadequate sensitivity of the standard test in human and veterinary medicine has necessitated development of alternate, more sensitive technologies.

Anemia, Hemolytic↗
PubMed1975

Platelet indirect radioactive Coombs test. Its utilization for PLA1 grouping.

A platelet indirect radioactive Coombs test (PIRC) has been described. The technique for purification and labelling the antiglobulin has been precised. This test allowed the typing of platelets in the PLA system by using an absorbed serum from a mother of a thrombocytopenic child. Six other families of neonatal thrombocytopenias were tested. In three of them, the mothers were found PLA1 negative (PLA2, PLA2). Among a panel of 93 platelets, two (0.022) were found PLA1, negative. This PIRC test has many advantages compared to other tests such as platelet complement fixation, assay for blocking antibodies or antiglobulin consumption: it gives objective and quantitative results and is highly reproducible; anticomplementary serum may be tested.

Animals↗
PubMed1980

[Use of the Coombs' test and the fluorescent antibody technic in order to detect incomplete antibodies in brucellosis patients].

The serological data obtained in the survey of persons working on cattle-breeding farms with registered cases of brucellosis and chronic brucellosis patients are presented. The survey was made with the use of the Coombs test and the indirect immunofluorescent method. The high diagnostic value of the Coombs antiglobulin test was confirmed. The data obtained by the Coombs test and the indirect immunofluorescent method in the detection of incomplete antibodies were found to be correlated.

Agglutination Tests↗