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Immunohematology. 2002;18(4):109-13.

Clinically significant autoimmune hemolytic anemia with a negative direct antiglobulin test by routine tube test and positive by column agglutination method.

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Transfusion Center, Catholic University of Sacred Heart, Largo Gemelli 8 00168 Rome, Italy.


In two to five percent of cases of autoimmune hemolytic anemia (AIHA),the patient's RBCs are negative in the direct antiglobulin test (DAT). We describe a patient with AIHA with a negative DAT when tested by the traditional tube test but with a strongly positive one when tested by column agglutination. When the DAT was repeated by tube test using 4 degrees Celsius saline washes, it became positive. This phenomenon has been observed when low-affinity antibodies are involved in AIHA. The patient's history and serologic findings are detailed in this report.


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