There is an ongoing subclinical activation of coagulation cascade and fibrinolytic system in thalassemia major (TM) patients. Higher levels of TAFI in the present study with no significant correlation with other parameters were noted, thus pointing out to its independent role in contribution to hypercoagulable state in thalassemia. TAFI serves as a link between two limbs of hemostasis, with its higher levels promoting inhibition of fibrinolytic system and thus promoting a hypercoagulable state. Performing TAFI levels in thalassemic patients could help to detect the early coagulopathy in these patients and hence these patients can be closely monitored for any evidence of thrombosis.
Direct Antiglobulin Test is a method of demonstrating the presence of antibody/ complement bound to red cell membrane by using AHG to form a visible agglutination reaction. DAT positivity is seen in immune mediated haemolytic anaemias, however rarely non immune mediate haemolytic anaemias also show DAT positivity. DAT positivity predictive of 83% of autoimmune haemolytic anaemia and 1.4% cases without haemolytic anaemia. Screening of blood donors for DAT is usually not recommended traditionally by any guidelines. However DAT positivity is reported in 0.008% of donors. On extensive search of literature we could find only very few studies on DAT positivity in donors. We report two cases of DAT positive donors with no clinical or laboratory evidence of hemolysis.
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