Disease relevance of Coombs' Test

• Positive direct antiglobulin tests and immune hemolytic anemia in patients receiving procainamide [1].
• Immune thrombocytopenia. Use of a Coombs antiglobulin test to detect IgG and C3 on platelets [2].
• This study suggests that in patients taking methyldopa who have a positive direct antiglobulin test the absence of hemolysis may be caused by an impairment in reticuloendothelial function [3].
• Valproic-acid-induced pancytopenia and Coombs test positivity [4].
• Manifestations included pleurisy in five of six patients, rashes in three, nephritis in two, and neurologic disturbances in two; lupus erythematosus cells were found in five patients, antinuclear antibodies in all six, antideoxyribonucleic acid in three, positive Coombs' test results for three patients, and low C4 complement in five of the six [5].

High impact information on Coombs' Test

• There was a significant increase in the frequency of positive direct antiglobulin tests in patients receiving procainamide (21 vs. 10 per cent, P = 0.05) [1].
• Erythrocytes (E) lacking high incidence blood group antigens were screened by an antiglobulin test with a monoclonal antibody to human complement receptor type 1 (CR1; C3b/C4b receptor; CD35) [6].
• Unlike autoimmune hemolytic anemia, which is characterized by an increased number of reticulocytes, positive Coombs test findings, and a high serum level of lactate dehydrogenase [7].
• During a phase I evaluation of diglycoaldehyde (INOX), an intravenous chemotherapeutic agent used to treat children with malignancies, all of eight patients tested developed a positive direct antiglobulin test (DAT) in vivo [8].
• In patients with SLE, anticardiolipin antibodies (aCL) have been associated with positive results on direct antiglobulin tests [9].

Chemical compound and disease context of Coombs' Test

• The incidence of positive Coombs' test was higher in high-dose cefepime recipients than in ceftazidime recipients (14.5% vs 8.7%; p = 0.043), although there was no evidence of hemolysis in either treatment group [10].
• We considered active autoimmune hemolytic anemia (AHA) as a decrease of at least 2 g/dL in hemoglobin levels, an increase of at least 0.6 mg/dL in the serum unconjugated bilirubin level, a reticulocyte count >5%, and a positive direct Coombs test [11].
• Although it was unclear whether the immune hemolytic anemia was the result of suprofen, tolmetin, or cross-reacting antibodies, we feel that suprofen should be added to the list of nonsteroidal anti-inflammatory drugs associated with a positive direct antiglobulin test [12].
• The most consistent effects of longterm multiple dosing with cefmetazole in dogs consisted of vomiting and retching during dosing and reversible haematological changes (mild regenerative anaemia, positive Coombs' test, clinically-silent thrombocytopenia) in a number of the dogs [13].
• The second case was a woman with HCV liver cirrhosis with severe anaemia and Coombs test positivity partially responsive to continuous administration of steroid high doses [14].

Biological context of Coombs' Test

• RESULTS: Non-complement fixing HLA antibodies were detected by ELISA in many sera that were lymphocytotoxicity test-negative; that is, 14 (17.5%) of 80 from refractory patients, 8 (23.5%) of 34 from those with febrile reactions, and 11 (22.4%) of 49 from those with nonspecific hemagglutination in the direct antiglobulin test [15].
• The frequencies of abnormal result of activated partial thromboplastin time, antinuclear factor, Coombs' test, and venereal disease research laboratory were 2.84%, 1.22%, 1.02%, and 1.34% in these 41 patients, respectively [16].
• Mitogen-stimulated direct antiglobulin test (MS-DAT) is a recently described test able to disclose latent anti-RBC autoimmunity in AIHA [17].
• DESIGN: The following were evaluated in all babies of Rh-D negative mothers born within a three month period in our department: haemoglobin level, packed cell volume, mean corpuscular volume, reticulocytes, bilirubin level, and direct Coombs' test (direct anti-globulin test) [18].
• Maternal and infants' blood groups and Rh, direct Coomb's test, G6PD screening test and hematocrit were determined on every infant [19].

Anatomical context of Coombs' Test

• Prevention of kernicterus in full term infants is based on the detection of neonates at risk for developing hyperbilirubinaemia, and can be accomplished with simple tests performed on umbilical cord blood such as blood type, Rh, Coombs' test and glucose-6-phosphate dehydrogenase, in order to detect haemolytic diseases [20].
• RESULTS: Serologic findings included a positive immunoglobulin G direct antiglobulin test; nonreactive red blood cell (RBC) eluates; platelet (PLT)-bound antibodies to glycophorin (GP) IIb-IIIa, GPIb-IX, and GPIa-IIa; and oxaliplatin-dependent antibodies to PLTs, RBCs, and neutrophils [21].
• To investigate an increased frequency of positive direct (DAT) and indirect (IAT) antiglobulin tests in bone marrow transplant (BMT) patients who received intravenous immunoglobulin (IVIG), serologic testing was performed weekly on blood samples from 94 consecutive BMT patients [22].
• Monocyte monolayer assay (MMA) reactivity of alloantibodies reacting by the manual polybrene technique but not by an antiglobulin test [23].
• Sera from 30 patients with acute Guillain-Barré syndrome were tested for the presence of antibodies to peripheral nerve tissue using the antiglobulin consumption test [24].

Associations of Coombs' Test with chemical compounds

• In vitro studies showed a transitory positive direct antiglobulin test (DAT) due to IgG, IgM, and C3 fixation [25].
• Erythrocyte-bound immunoglobulins have been characterized by a PVP-potentiated antiglobulin test in 11 patients who had developed antibodies after treatment with alpha-methyldopa [26].
• In contrast, the ETCOc for infants with ABO or Rh incompatibility, a positive direct Coombs' test, and bilirubin > 130 mg/L (n = 9) was significantly higher, 1.8 +/- 0.8 microL/L, than for those who had a positive Coombs' test result but whose bilirubin was < or = 130 mg/L (n = 12), 1.0 +/- 0.5 microL/L (P < 0.05) [27].
• Positive direct antiglobulin tests due to clavulanic acid [28].
• Of 23 antibiotic courses in patients treated with ticarcillin, clavulanic acid, and tobramycin, 10 (43.5%) developed positive direct antiglobulin tests versus 2 of 26 (7.7%) patients treated with piperacillin and tobramycin (P = 0.0044) [28].

Gene context of Coombs' Test

• Furthermore, the reaction was accompanied by a strongly positive Coombs test and increased TNF-alpha and IL-10 serum levels which returned to normal following anti-inflammatory drug administration [29].
• DNA antibody, and direct antiglobulin test were observed in 30%, 14%, 7% and 12%, respectively, and a CD4/CD8 ratio < 1 was observed in 20% [30].
• Direct coombs test and protein C, C3, and C4 were also within normal levels [31].
• The mixed antiglobulin test detected antibody in the sera of patients on chronic dialysis two to four times more frequently than did either the immune adherence test or the most sensitive modification of the microlymphocytotoxicity test which was utilized [32].
• The direct antiglobulin test was positive in all but one case; this finding coincided with elevated unconjugated bilirubin in 14 cases and decreased haptoglobin levels in 15 cases [33].

Analytical, diagnostic and therapeutic context of Coombs' Test

• Immunological tests for autoantibodies were positive in 25 of 53 dogs tested in the antinuclear antibody (ANA) test, in 15 of 43 dogs tested in the latex test and in five of 24 dogs tested in the Coombs test [34].
• An enzyme-linked antiglobulin test to quantify nanogram quantities of IgG on polystyrene microspheres [35].
• The development of the immune response was compared by the rose bengal test, the complement fixation test, the Coombs' test and the immunocapture technique for 180 days after the vaccination and for 410 days after the experimental infection, that is, the two following gestations [36].
• RESULTS: Infants who were ABO-incompatible and showed positive results to the direct antiglobulin test had the highest incidence of jaundice and underwent more tests and phototherapy [37].
• This task can be accomplished by performing a simple umbilical cord blood test, such as blood group, Rh, Coombs' test and glucose-6-phosphate dehydrogenase, in order to detect hemolytic diseases [38].

References