How does a positive direct Coombs test (direct antiglobulin test) (DAT) affect the prognosis of cold agglutinin disease?

Updated: Aug 28, 2018
  • Author: Salman Abdullah Aljubran, MD; Chief Editor: Michael A Kaliner, MD  more...
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Answer

A study by Kamesaki et al indicated that the clinical characteristics of patients with autoimmune hemolytic anemia who have a positive direct Coombs test (direct antiglobulin test [DAT]) differ from those of patients with this type of anemia and a negative DAT. The report used data from 216 patients with autoimmune hemolytic anemia, including 154 who were DAT negative and 62 who were DAT positive. [46]

The investigators found that patients who were DAT negative tended to have milder anemia and hemolysis than did patients who were DAT positive and that they needed significantly lower steroid doses during maintenance treatment. The 2 groups of patients were found to have an equally good response to steroids. Survival at 1-year follow-up for each group was comparable to that of the other.


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