Warm Autoimmune Hemolytic Anemia and Direct Antiglobulin Testing With a False-Negative Result in a 53-Year-Old Man: The DAT Will Set You Free.
Warm autoimmune hemolytic anemia (WAIHA), the most common of the relatively uncommon autoimmune-mediated hemolytic anemias (AIHAs), is mediated by polyclonal immunoglobulin (Ig)G autoantibodies in most cases. Herein, we present a case of WAIHA involving a direct antiglobulin test (DAT) with an initially negative result. Using a modified DAT protocol, repeat testing of the same specimen material from a previously healthy 53-year-old man yielded positive results. This case demonstrates that investigation of an apparently negative DAT result plays a critical role in the differential diagnosis of patients with rapidly progressing hemolytic anemia and the reversal of that decline.
Department of Pathology, The Ohio State University Wexner Medical Center.
Michael
M
Losos
Department of Pathology, The Ohio State University Wexner Medical Center.
Diane
D
Hamad
Department of Hematology, Nationwide Children's Hospital, Columbus, Ohio.
Sarita
S
Joshi
Department of Pathology, The Ohio State University Wexner Medical Center.
Scott
S
Scrape
Department of Pathology, The Ohio State University Wexner Medical Center, jian.chen2@osumc.edu.
Jian
J
Chen
D000744:Anemia, Hemolytic, Autoimmune / Q000175:diagnosis*; D000888:Antibodies, Anti-Idiotypic / Q000097:blood*; D003955:Diagnostic Tests, Routine / Q000379:methods*; D005188:False Negative Reactions; D006801:Humans; D007118:Immunoassay / Q000379:methods*; D008297:Male; D008875:Middle Aged
D000888:Antibodies, Anti-Idiotypic
DAT negative; DAT protocol; WAIHA diagnosis; WAIHA treatment; direct antiglobulin test (DAT); warm autoimmune hemolytic anemia (WAIHA)