Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.
Department of Pathology, Division of Transfusion Medicine, Stanford University School of Medicine, Stanford, California.
Transfusion. 2019 Aug;59(8):2528-2531. doi: 10.1111/trf.15350. Epub 2019 May 21.
The diagnosis of autoimmune hemolytic anemia (AIHA) can be challenging since the direct antiglobulin test (DAT) has been reported to be falsely negative in 3%-11% of cases. In children with anemia, laboratory and/or clinical evidence of hemolysis and a negative DAT, clinicians should consider further specialized testing to confirm AIHA to accurately diagnose and treat this uncommon pediatric entity.
A retrospective chart review was undertaken at a large tertiary care academic pediatric hematology practice to describe our experience with DAT-negative AIHA.
From January 1, 2010 through August 1, 2016, 10 children were described who had clinical and laboratory evidence of AIHA, a negative DAT, and further specialized serologic testing confirming this diagnosis.
This case series highlights the need for further serologic workup when a child's clinical presentation is highly consistent with AIHA despite a negative DAT.
自身免疫性溶血性贫血 (AIHA) 的诊断具有一定挑战性，因为已有报道称 3%-11%的病例直接抗球蛋白试验 (DAT) 结果呈假阴性。对于贫血儿童，如果实验室和/或临床有溶血的证据且 DAT 为阴性，临床医生应考虑进一步进行专门的检测以明确 AIHA 的诊断，从而准确诊断和治疗这种罕见的儿科疾病。
在一家大型三级儿童血液学学术医疗中心进行了回顾性图表审查，以描述我们在 DAT 阴性 AIHA 方面的经验。
2010 年 1 月 1 日至 2016 年 8 月 1 日，共描述了 10 名患儿，他们均具有 AIHA 的临床和实验室证据、DAT 阴性和进一步的专门血清学检测以确认该诊断。
尽管 DAT 为阴性，但当患儿的临床表现高度符合 AIHA 时，本病例系列强调了需要进行进一步的血清学检查。
