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Evaluation of the Use of Gel Card System for Assessment of Direct Coombs Test
A positive direct Coombs test is the
hallmark of diagnosis of immune hemolytic anemias. The reagent used for the
test is the Antihuman globulin (AHG), which may be either ‘Polyspecific’ or ‘Monospecific’.
The advent of the Gel
card systems has made the procedure and interpretation of DCT simpler.
Aim of this study is to evaluate three of the various techniques used for the
performance and interpretation of DCT. A total of 96 EDTA
samples were included in the study. DCT was performed by (i)
polyspecific AHG manual tube method (ii) polyspecific AHG Gel card method and
(iii) monospecific AHG (Anti IgG and Anti Complement) manual tube method.
In our study we considered positivity by
monospecific AHG as the standard for diagnosis. Of the total 96 samples
evaluated, 44 cases positive by Gel card method, were also positive for either
one or both the monospecific AHG reagents. 17 cases positive by Gel card were
negative by all manual methods. These false positive cases were attributed to
reasons such as increased ESR, macrocytosis and marked leucocytosis. Nine cases
were negative by Gel card but were positive with the Monospecific AHG.
The sensitivity of DCT done by the Gel card
technique was 83.01% and the specificity was 60.46%. Use of Gel card technique
to perform and interpret DCT is easier than manual tube methods, but positivity
by Gel card needs to be correlated with
clinical presentation of the patient and other laboratory findings.
Monospecific antisera can be used to confirm cases that are positive by the Gel
card systems.
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