A case series of pediatric patients with direct antiglobulin test negative autoimmune hemolytic anemia

Transfusion. 2019 Aug;59(8):2528-2531. doi: 10.1111/trf.15350. Epub 2019 May 21.

Abstract

Background: The diagnosis of autoimmune hemolytic anemia (AIHA) can be challenging since the direct antiglobulin test (DAT) has been reported to be falsely negative in 3%-11% of cases. In children with anemia, laboratory and/or clinical evidence of hemolysis and a negative DAT, clinicians should consider further specialized testing to confirm AIHA to accurately diagnose and treat this uncommon pediatric entity.

Study design and methods: A retrospective chart review was undertaken at a large tertiary care academic pediatric hematology practice to describe our experience with DAT-negative AIHA.

Results: From January 1, 2010 through August 1, 2016, 10 children were described who had clinical and laboratory evidence of AIHA, a negative DAT, and further specialized serologic testing confirming this diagnosis.

Conclusion: This case series highlights the need for further serologic workup when a child's clinical presentation is highly consistent with AIHA despite a negative DAT.

Publication types

  • Case Reports
  • Clinical Trial

MeSH terms

  • Adolescent
  • Adult
  • Anemia, Hemolytic, Autoimmune / blood*
  • Anemia, Hemolytic, Autoimmune / diagnosis*
  • Child
  • Child, Preschool
  • Coombs Test*
  • Female
  • Humans
  • Infant
  • Male
  • Retrospective Studies