Biñas, Celestina, C.

BSMLS 3-A-IRR 1

WEEK 13 & 14: DIRECT COOMBS TEST

CRITICAL THINKING SKILLS:

1. Explain why HDN, AIHA, and HTR will give positive reaction in DAT.
 The principle of DAT is to detect the presence of antibodies attached directly to the RBCs, which
takes place by washing a collected blood sample in saline to isolate the patient’s RBCs; this
procedure removes unbound antibodies that may otherwise confound the result. The mentioned
clinical conditions produce a positive result as they undergo in-vivo sensitization of the RBCs
wherein for hemolytic disease of the newborn (HDN) there is the coating of maternal antibody on
fetal RBCs, for hemolytic transfusion reaction (HTR) there is the coating of recipient antibody on
donor RBCs, and for autoimmune hemolytic anemia (AIHA) there is the coating of autoantibodies
on the individuals’ RBCs.

2. Why do you think, washed Red Cell should be used in the procedure and not whole blood?
 The reason why washed red cell is used and not the whole blood in the Direct Antiglobulin Test
(DAT) is to ensure that the unbound antibodies have been removed to prevent false-negative
results.

3. Why do you think AHG reagent is developed to detect IgG antibodies and not IgM antibodies?
 IgM antibodies are large enough to directly agglutinate RBCs suspended in saline in which their
reaction can be observed readily but for IgG, they are too small to elicit an observable reaction.