Mendes Isadora Cristina, de Assis Pâmela Cristina Gomes Farias, de Almeida Raíssa Santos, de Sousa Luma Romeiro Rodrigues, Carneiro Lilian Carla, Jesuino Rosália Santos Amorim
Universidade Federal de Goiás (UFG), Goiânia, GO, Brazil.
Universidade Federal de Goiás (UFG), Goiânia, GO, Brazil.
Hematol Transfus Cell Ther. 2024 Nov;46 Suppl 5(Suppl 5):S65-S71. doi: 10.1016/j.htct.2024.04.118. Epub 2024 May 8.
To clinically and laboratory characterize patients with a positive direct antiglobulin test (DAT) treated at the Hospital das Clínicas of the Federal University of Goiás (HC-UFG).
A retrospective, descriptive, cross-sectional study was carried out collecting data from medical records of patients with a positive DAT who were treated at HC-UFG between August 2021 and August 2022.
Eighty-four patients with positive polyspecific DAT results were screened in the clinical laboratory. Fifty-four patients had a laboratory profile compatible with autoimmune hemolytic anemia (AIHA), however, among these, 16 patients already had a diagnosis of AIHA in their medical records. The most common symptoms present among AIHA patients were pallor, asthenia, fatigue and dyspnea. For the remaining patients, the most common symptoms were severe thrombocytopenia, anemia, renal dysfunction, fever, myalgia, headache, thrombosis, asthenia, hematuria and joint pain. Only one patient had primary AIHA, that is, he had no evident underlying disease. The majority of AIHA patients (75 %) underwent corticosteroid therapy with 60 % having a positive response. For patients without AIHA, prednisone was the most frequently prescribed medication in 17 (25 %) patients, followed by hydroxychloroquine (14 patients - 20.1 %).
It is essential to evaluate patients with positive DAT in detail in order to understand the real clinical case. The DAT serological result alone does not arrive at a conclusive diagnosis of AIHA, and so it must be evaluated in conjunction with both clinical data and other laboratory tests, such as hemoglobin concentration and hemolysis tests (reticulocytes, lactate dehydrogenase and/or haptoglobin).
对在戈亚斯联邦大学临床医院（HC-UFG）接受治疗的直接抗球蛋白试验（DAT）呈阳性的患者进行临床和实验室特征分析。
开展一项回顾性、描述性横断面研究，收集2021年8月至2022年8月期间在HC-UFG接受治疗的DAT呈阳性患者的病历数据。
临床实验室筛查出84例多特异性DAT结果呈阳性的患者。54例患者的实验室检查结果符合自身免疫性溶血性贫血（AIHA），然而，其中16例患者在病历中已有AIHA诊断。AIHA患者中最常见的症状是面色苍白、乏力、疲劳和呼吸困难。其余患者最常见的症状是严重血小板减少、贫血、肾功能不全、发热、肌痛、头痛、血栓形成、乏力、血尿和关节疼痛。只有1例患者患有原发性AIHA，即他没有明显的基础疾病。大多数AIHA患者（75%）接受了皮质类固醇治疗，其中60%有阳性反应。对于非AIHA患者，泼尼松是17例（25%）患者中最常开具的药物，其次是羟氯喹（14例患者 - 占20.1%）。
详细评估DAT呈阳性的患者对于了解实际临床情况至关重要。仅DAT血清学结果不能得出AIHA的确切诊断，因此必须结合临床数据和其他实验室检查，如血红蛋白浓度和溶血试验（网织红细胞、乳酸脱氢酶和/或触珠蛋白）进行评估。
