Kindly explain about Coombs test used to diagnose cold-agglutinin-disease.

Hello,

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I am trying to explain to you about the Coombs test.

Basically, this test detects antibody-coated red blood cells. The direct Coombs test detects antibody coated on red blood cells. In cold agglutinin disease, the IgM antibody coat the red blood cells. So direct Coombs test is for testing for cold agglutinin disease in which antibody-coated red blood cells can be detected. In this procedure, Coombs serum means AHG is used to detect the antibody. So if direct Coombs test is positive at low temperature (because antibody in this disease bind to red blood cells at low temperature) then it suggests cold agglutinin disease.

However, clinical correlation in the form of liver and spleen palpation should be done along with peripheral smear examination report for further workup.