What is the role of direct antiglobulin testing in the evaluation of hemolytic anemia?

Updated: May 27, 2021
  • Author: Srikanth Nagalla, MD, MS, FACP; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

The DAT result is usually positive in autoimmune hemolytic anemia (AIHA), but it may occasionally be negative in this disorder. DAT-negative AIHAs have been reviewed. [36] From 5-10% of all AIHAs are DAT negative. The polybrene test can detect DAT-negative AIHA. [36] In addition, the immunoradiometric assay (IRMA) for red blood cell–bound IgG can be used to diagnose AIHA in patients whose autoantibody levels are too low to be detected by conventional DAT. [37] DAT-negative AIHA has a better prognosis than DAT-positive AIHA. [38]


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