The role of conventional tube and column agglutination technique in predicting hemolysis in various clinical conditions
Introduction: The correlation of positive result in direct antiglobulin test (DAT) with in vivo hemolysis is important for the patient management. This study compares the correlation of tube-DAT and -DAT by column agglutination technique (CAT) with in vivo hemolysis and reviews the appropriateness o...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2018-01-01
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| Series: | Global Journal of Transfusion Medicine |
| Subjects: | |
| Online Access: | http://www.gjtmonline.com/article.asp?issn=2468-8398;year=2018;volume=3;issue=2;spage=128;epage=131;aulast=Shastry |
| _version_ | 1818986460484730880 |
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| author | Shamee Shastry Rajendra Chaudhary |
| author_facet | Shamee Shastry Rajendra Chaudhary |
| author_sort | Shamee Shastry |
| collection | DOAJ |
| description | Introduction: The correlation of positive result in direct antiglobulin test (DAT) with in vivo hemolysis is important for the patient management. This study compares the correlation of tube-DAT and -DAT by column agglutination technique (CAT) with in vivo hemolysis and reviews the appropriateness of the requests for DAT in patients with various clinical conditions. Patients and Methods: A total of 250 consecutive patients referred for DAT were enrolled for the study. Laboratory indicators of hemolysis were obtained from the computerized hospital data management system. Hemolysis in patients was graded using predetermined criteria. DAT was done using CAT and tube techniques and graded on the agglutination pattern. Results: Among 250 patients studied, 160 patients were from the hemato-oncology unit, and 47 had an autoimmune disease. Laboratory evidence of hemolysis was seen in 170 patients (severe: 45.88% and moderate: 54.12%). Positive DAT by tube technique was seen in only 41 out of 65 patients whose DAT was positive by CAT. Hemolytic anemia was the single largest cause in this group. Positive predictive values (PPVs) of tube and CAT were comparable. On comparing the strength of agglutination with the in vivo-hemolysis, 1+ reaction by CAT had low PPV.
Conclusion: The present study shows that mere DAT positivity does not always indicate in vivo hemolysis. Hence, while recommending the routine use of CAT for DAT, we suggest to incorporate the strength of agglutination reaction in laboratory report for the ease of interpretation. |
| first_indexed | 2024-12-20T18:51:09Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2468-8398 2455-8893 |
| language | English |
| last_indexed | 2024-12-20T18:51:09Z |
| publishDate | 2018-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Global Journal of Transfusion Medicine |
| spelling | doaj.art-782ac389cf8a408a9860cd88e079e9bc2022-12-21T19:29:36ZengWolters Kluwer Medknow PublicationsGlobal Journal of Transfusion Medicine2468-83982455-88932018-01-013212813110.4103/GJTM.GJTM_23_18The role of conventional tube and column agglutination technique in predicting hemolysis in various clinical conditionsShamee ShastryRajendra ChaudharyIntroduction: The correlation of positive result in direct antiglobulin test (DAT) with in vivo hemolysis is important for the patient management. This study compares the correlation of tube-DAT and -DAT by column agglutination technique (CAT) with in vivo hemolysis and reviews the appropriateness of the requests for DAT in patients with various clinical conditions. Patients and Methods: A total of 250 consecutive patients referred for DAT were enrolled for the study. Laboratory indicators of hemolysis were obtained from the computerized hospital data management system. Hemolysis in patients was graded using predetermined criteria. DAT was done using CAT and tube techniques and graded on the agglutination pattern. Results: Among 250 patients studied, 160 patients were from the hemato-oncology unit, and 47 had an autoimmune disease. Laboratory evidence of hemolysis was seen in 170 patients (severe: 45.88% and moderate: 54.12%). Positive DAT by tube technique was seen in only 41 out of 65 patients whose DAT was positive by CAT. Hemolytic anemia was the single largest cause in this group. Positive predictive values (PPVs) of tube and CAT were comparable. On comparing the strength of agglutination with the in vivo-hemolysis, 1+ reaction by CAT had low PPV. Conclusion: The present study shows that mere DAT positivity does not always indicate in vivo hemolysis. Hence, while recommending the routine use of CAT for DAT, we suggest to incorporate the strength of agglutination reaction in laboratory report for the ease of interpretation.http://www.gjtmonline.com/article.asp?issn=2468-8398;year=2018;volume=3;issue=2;spage=128;epage=131;aulast=ShastryAutoantibodycolumn agglutination techniquedirect antiglobulin testhemolysistube test |
| spellingShingle | Shamee Shastry Rajendra Chaudhary The role of conventional tube and column agglutination technique in predicting hemolysis in various clinical conditions Global Journal of Transfusion Medicine Autoantibody column agglutination technique direct antiglobulin test hemolysis tube test |
| title | The role of conventional tube and column agglutination technique in predicting hemolysis in various clinical conditions |
| title_full | The role of conventional tube and column agglutination technique in predicting hemolysis in various clinical conditions |
| title_fullStr | The role of conventional tube and column agglutination technique in predicting hemolysis in various clinical conditions |
| title_full_unstemmed | The role of conventional tube and column agglutination technique in predicting hemolysis in various clinical conditions |
| title_short | The role of conventional tube and column agglutination technique in predicting hemolysis in various clinical conditions |
| title_sort | role of conventional tube and column agglutination technique in predicting hemolysis in various clinical conditions |
| topic | Autoantibody column agglutination technique direct antiglobulin test hemolysis tube test |
| url | http://www.gjtmonline.com/article.asp?issn=2468-8398;year=2018;volume=3;issue=2;spage=128;epage=131;aulast=Shastry |
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