MacNeill Amy L, Dandrieux Julien, Lubas George, Seelig Davis, Szladovits Balázs
Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA.
Faculty of Veterinary and Agricultural Sciences, Translational Research and Animal Clinical Trial Study (TRACTS) Group, The University of Melbourne, Werribee, Vic., Australia.
Vet Clin Pathol. 2019 Oct;48 Suppl 1:7-16. doi: 10.1111/vcp.12771. Epub 2019 Sep 9.
A definitive diagnosis of immune-mediated hemolytic anemia (IMHA) can be difficult to make. However, it is critical to differentiate IMHA from other causes of anemia due to the impact on prognosis and outcome for IMHA patients. Recently published American College of Veterinary Internal Medicine recommendations for the diagnosis of IMHA should be followed to concurrently confirm ongoing anemia, verify in vivo hemolysis, and detect anti-erythrocyte antibodies. The reliability of immunologic IMHA tests varies depending on which test is used and how it is performed.
Our aims were to determine which tests are currently used in veterinary medicine to diagnose IMHA and review the utility of assays that have historically been used to diagnose IMHA.
A short survey was designed to see which diagnostic tests for IMHA were currently being used by veterinary practices. The survey was distributed via list-serves to veterinarians and veterinary technologists. A literature review was performed to report the utility of diagnostic tests for the diagnosis of IMHA.
Survey respondents indicated a variability in test protocols used to diagnose IMHA. Most respondents perform saline agglutination or Coombs' tests to detect anti-erythrocyte antibodies. Additional tests that can be used to support a diagnosis of IMHA are discussed in this review.
A standardized diagnostic approach should be followed to differentiate IMHA from other causes of anemia. Test methodology can vary from one laboratory to another, and clinicians should be familiar with the procedures used by their laboratory.
免疫介导性溶血性贫血（IMHA）的明确诊断可能具有挑战性。然而，鉴于其对IMHA患者预后和结局的影响，将IMHA与其他贫血原因区分开来至关重要。应遵循美国兽医内科学会最近发布的IMHA诊断建议，以同时确认持续性贫血、验证体内溶血情况并检测抗红细胞抗体。免疫性IMHA检测的可靠性因所使用的检测方法及其操作方式而异。
我们的目的是确定目前兽医学中用于诊断IMHA的检测方法，并回顾历史上用于诊断IMHA的检测方法的效用。
设计了一项简短调查，以了解兽医诊所目前正在使用哪些IMHA诊断检测方法。该调查通过邮件列表分发给兽医和兽医技术人员。进行了文献综述，以报告IMHA诊断检测方法的效用。
调查受访者表示，用于诊断IMHA的检测方案存在差异。大多数受访者进行盐水凝集试验或库姆斯试验以检测抗红细胞抗体。本综述讨论了可用于支持IMHA诊断的其他检测方法。
应采用标准化的诊断方法将IMHA与其他贫血原因区分开来。不同实验室的检测方法可能不同，临床医生应熟悉其所在实验室使用的程序。
