[A new approach for diagnosis of autoimmune hemolytic anemia].
Sixty four cases of autoimmune hemolytic anemia (AIHA) referred to our laboratory from 1985 to 1993 consisted of 51 warm type AIHA, 9 cold agglutinin disease (CAD), one paroxysmal cold hemoglobinuria, and 3 mixed type AIHA. There were 5 patients who had all clinical features of AIHA except for a positive direct-antiglobulin test (DAT). These patients were diagnosed as DAT-negative AIHA because of the elevation of red blood cell-associated IgG (RBC-IgG). The mean RBC-IgG of 100 healthy individuals was 33 +/- 13 (SD) molecules per one RBC. On the other hand, the RBC-IgG of patients with DAT-positive and with DAT-negative warm type AIHA were ranged from 257 to 12,421 and from 126 to 256 molecules per one RBC, respectively. One of 9 patients with CAD had a hemolytic anemia associated with only a cold agglutinin titer of 32 using saline-suspended RBCs, but a titer of 4,096 in the presence of bovine albumin. This case was diagnosed as low titer CAD. All of patients with DAT-negative AIHA or low titer CAD showed a good response to corticosteroid treatment.
Department of Legal Medicine and Human Genetics, Jichi Medical School.
E
E
Kajii
T
T
Omi
Y
Y
Miura
S
S
Ikemoto
D000744:Anemia, Hemolytic, Autoimmune / Q000145:classification / Q000175:diagnosis*; D004912:Erythrocytes / Q000378:metabolism; D006386:Hemagglutination Tests; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis / Q000378:metabolism; D011485:Protein Binding
D007074:Immunoglobulin G