Friday, 4 September 2015

Coombs Test

A) DIRECT COOMBS TEST:-

(also known as the direct antiglobulin test or DAT)

● detect antibodies or complement bound to RBC surface antigens in vivo.

●used for:-
1) immune-mediated hemolytic anemia
2) Hemolytic disease of the newborn
3) Rh D hemolytic disease of the newborn
4) ABO hemolytic disease of the newborn
5) Drug-induced immune-mediated hemolysis
6) Transfusion reaction, such as one due to improperly matched units of blood

B) INDIRECT COOMBS TEST :-

(also known as the indirect antiglobulin test or IAT)
●detect in-vitro antibody-antigen reactions

●used for:-

1) detection of very low concentrations of antibodies present in a patient's plasma/serum prior to a blood transfusion
2) in antenatal care, the IAT is used to screen pregnant women for antibodies that may cause hemolytic disease of the newborn
3) compatibility testing
4) antibody identification
5) RBC phenotyping
6) titration studies.



?☺: Tumor Lysis Syndrome

* Most commonly seen with acute leukemias, Burkitt lymphoma and other lympho-reticular malignancies (uncommon in solid tumors).
* Chemotherapy results in death of large quantities of cells, which leads to release of massive amounts of potassium, uric acid and other breakdown products into the blood.
* It develops within hours to few days of initiation of chemotherapy.

* Features:
- hypocalcemia
- renal failure due to precipitation of uric acid crystals or calcium phosphate crystals in the kidney
- hyperkalemia leading to arrhythmias
- hyperphosphatemia

* Management
- vigorous IV hydration with half normal saline
- correction of metabolic abnormalities
- hemodialysis in severe cases

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