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How to use: the direct antiglobulin test in newborns
  1. Amy Keir1,
  2. Minda Agpalo2,
  3. Lani Lieberman3,4,
  4. Jeannie Callum2,4
  1. 1Robinson Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, Australia
  2. 2Transfusion Medicine and Tissue Banks, Sunnybrook Health Sciences Centre, Toronto, Canada
  3. 3Department of Clinical Pathology, University Health Network, Toronto, Canada
  4. 4Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Canada
  1. Correspondence to Dr Amy Keir, Department of Neonatal Medicine, Women's and Babies’ Division, Women's and Children's Health Network, WCH Campus/1st Floor, Queen Victoria Building, 72 King William Road, North Adelaide, SA 5006, Australia; amy.keir{at}adelaide.edu.au

Abstract

The direct antiglobulin test (DAT) detects the presence of immunoglobulin, complement or both bound to the red blood cell membrane. The test, historically called the ‘Coombs test’, was first described in 1945 by Cambridge immunologist Robin Coombs. Suspected haemolytic disease of the newborn, due to either Rhesus disease or ABO incompatibility, is one of most common reasons for requesting a DAT in newborns. In this article, we discuss the physiological background and technological background of the DAT. We also provide a clinical framework for a rational approach to the use and interpretation of the DAT in newborns.

  • Neonatology
  • Haematology
  • Jaundice

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