DAT 阴性自身免疫性溶血性贫血。

DAT-Negative Autoimmune Hemolytic Anemia.

机构信息

Immunohematology Reference Labs, Northern and Southern California, American Red Cross, 100 Red Cross Circle, Pomona, CA 91768, USA.

出版信息

Hematol Oncol Clin North Am. 2022 Apr;36(2):307-313. doi: 10.1016/j.hoc.2021.11.004. Epub 2022 Mar 10.

DOI:10.1016/j.hoc.2021.11.004

PMID:35282952

Abstract

Hematologists often rely on the results of a positive direct antiglobulin test to confirm a diagnosis of autoimmune hemolytic anemia, but immune hemolytic anemia can occur when no immunoglobulin is detectable by routine methods. Negative DATs in these patients may be due to a small quantity of IgG on their red blood cells (RBCs) (below detectable levels), or when low-affinity anti-IgG is present, or when the autoantibodies are IgA or IgM in nature. A panel of tests developed to detect immunoglobulins on these patients' RBCs may be performed in a few specialized laboratories. These tests can be helpful in instances whereby the clinical picture of AIHA seems obvious, but the laboratory values are misleading.

摘要

血液学家通常依赖阳性直接抗球蛋白试验的结果来确诊自身免疫性溶血性贫血，但在常规方法无法检测到免疫球蛋白时，也可能发生免疫性溶血性贫血。这些患者的 DAT 阴性可能是由于其红细胞（RBC）上的 IgG 量较少（低于检测水平），或者当存在低亲和力抗 IgG 时，或者当自身抗体本质上是 IgA 或 IgM 时。在少数专门的实验室中，可以对这些患者的 RBC 上的免疫球蛋白进行一系列检测。在自身免疫性溶血性贫血的临床表现明显但实验室值有误导的情况下，这些检测可能会有所帮助。