1965
DOI: 10.1136/jcp.18.1.119
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The direct antiglobulin (Coombs) test in megaloblastic anaemia

Abstract: SYNOPSIS Folic acid deficiency with the picture of a megaloblastic bone marrow may develop in haemolytic anaemia, and, on the other hand, both vitamin B12 and folic acid deficiency may produce signs of haemolysis. As the correct interpretation of a positive antiglobulin reaction associated with megaloblastic erythropoiesis is particularly important, the effect of deficiency of vitamin B12 and folic acid on the results of the test was investigated in 32 patients with vitamin B12 or folic acid deficiency and a p… Show more

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Cited by 11 publications
(7 citation statements)
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“…In such cases, if anemia does not respond to vitamin B12 supplementation, corticosteroid therapy or therapeutic splenectomy is indicated. Forshaw and Harwood [8] studied the association of a positive antiglobulin reaction with megaloblastic erythropoiesis. Thirty-two patients with megaloblastic anemia were investigated, and the direct antiglobulin test was positive in 10.…”
Section: Discussion/conclusionmentioning
confidence: 99%
“…In such cases, if anemia does not respond to vitamin B12 supplementation, corticosteroid therapy or therapeutic splenectomy is indicated. Forshaw and Harwood [8] studied the association of a positive antiglobulin reaction with megaloblastic erythropoiesis. Thirty-two patients with megaloblastic anemia were investigated, and the direct antiglobulin test was positive in 10.…”
Section: Discussion/conclusionmentioning
confidence: 99%
“…The association of pernicious antemia and a weakly positive antiglobulin test is not considered significant. Recorded cases were not complicated by overt haemolytic anaemia or even compensated hemolysis (Forshau & Harwood 1965, Henneman 1956, Wenner 1959. It seems possible that in these cases gammaglobulins, devoid of antierythrocytic activity, were nonspecifically bound to the red cell membrane.…”
Section: Commentmentioning
confidence: 97%
“…First, the transiently positive antibody does not appear to cause hemolysis ; the reticulocyte count is low (16) and increases only after cobalamin replacement. Second, the positive direct Coombs' test usually disappears with cobalamin treatment in those patients (19,20), and there is no role for corticosteroids. The cause of this transient phenomenon is unknown.…”
Section: ) Megaloblastic Anemiamentioning
confidence: 99%
“…The ineffective erythropoiesis and hemolytic component of cobalamin deficiency can produce increased lactate dehydrogenase activity (lo), indirect hyperbilirubinemia (1 1, 12), a decreased serum haptoglobin level (13), decreased erythrocyte survival (14-16), and occasionally even methemalbuminemia (13) and hemosiderinuria (17). Furthermore, a positive direct Coombs' test is a common finding in untreated pernicious anemia (18)(19)(20). The Coombs' test usually becomes negative after treat-ment with cobalamin, however, and the antibody does not appear to cause hemolysis (19,20).…”
mentioning
confidence: 99%
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