DAT Negative Hemolytic Anemia Evaluation

Overview

  • EPIC Code:
  • MISC
  • Soft Test Code:
  • MSOT
  • Send Out Test Code:
  • 3111
Alternate Names
  • DAT Negative Workup
  • Immune Hemolytic Anemia Evaluation
  • Micro Coombs
  • Super Coombs
Included Tests

 ABO/Rh, Direct Antiglobulin Tests (including IgA detection); Elution (routine and enhanced); Antibody detection tests (routine and enhanced). additional tests as necessary based upon results determined by Immunohematology Reference Lab


Clinical Significance

 Evaluation of patients developing hemolysis in the absence of serologic evidence to support a diagnosis of immune-mediated hemolytic anemia. Results may allow diagnosis of autoimmune hemolytic anemia, thereby assisting the physician in management of the patient.


Specimen Collection & Preparation

Specimen Requirements

3 - 7.0 mlL Whole Blood Red Top Tubes
and 
2 - 5.0 mL Whole Blood in a Lavender Top Tubes - EDTA 

Alternate Specimen

 

TransportAndStorage

 

Collection Instructions

 

Clinical Interpretation

Reference Range:

Please Refer to interpretive report


Test Comments:

 Negative results do not completely rule out the presence of immune-mediated hemolytic anemia. Positive test results are not absolutely diagnostic of immune hemolytic anemia and must be used in combination with clinical information to make a diagnosis


Methodology:
  • Serological

Clinical Significance

 Evaluation of patients developing hemolysis in the absence of serologic evidence to support a diagnosis of immune-mediated hemolytic anemia. Results may allow diagnosis of autoimmune hemolytic anemia, thereby assisting the physician in management of the patient.


Documentation

 A negative Direct Antiglobulin Test (DAT) is seen in approximately 1% of patients presenting with signs and symptoms of immune hemolysis. A well-performed standard DAT detects approximately 100-500 molecules of bound IgG per red cell. Our laboratory performs a more sensitive DAT1 (“super Coombs”) in order to confirm a diagnosis of autoimmune hemolytic anemia in patients whose samples have tested negative in a standard DAT for any of the following reasons: • Patient RBCs are sensitized with small numbers of IgG molecules, below the level of detection of the standard DAT. • Low-affinity IgG autoantibodies are eluted from RBCs during routine washing of the RBCs prior to the detection phase of the standard DAT. • IgA autoantibodies not detected by a standard DAT that is performed using monoclonal AHG


Production Schedule

Turn Around Time

3 days


Coding & Compliance

CDM

00913333


CPT Coding

86880x8, 86860, 86850x5, 86900, 86901, 86870