Should an indirect antiglobulin test be used in the investigation of immune hemolytic anemia?
A. An indirect antiglobulin test, or a red cell antibody screen, can be useful in determining autoimmune hemolytic anemia. If the patient has been transfused recently, you need to rule out the presence of alloantibodies as a cause of hemolysis. Even without a history of recent transfusion, the results would help in assessing the quantity and avidity of autoantibody present. While the antibody screen result, by itself, does not help you determine whether autoimmune hemolysis is present, it does help the laboratory to understand how difficult subsequent unit selection and crossmatching may be if transfusion is necessary. The presence of strongly reactive panagglutinin activity in the serum indicates that a great deal of autoadsorption likely would be needed to ensure that red cell alloantibodies are not present. For these reasons, plus the simplicity of the test, most laboratories include an antibody screen during the workup of possible autoimmune hemolytic anemia. This response should n
