What Do You Do if You Suspect a Warm Autoantibody?

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The page below is a sample from the LabCE course Warm Antibodies and Autoantibodies in Blood Banking. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

Learn more about Warm Antibodies and Autoantibodies in Blood Banking (online CE course)
What Do You Do if You Suspect a Warm Autoantibody?

First, you need to exclude underlying alloantibodies. Workups may vary amongst facilities but may include performing the following:
  • Direct Antiglobulin Test (DAT)
  • Elution
  • Patient phenotyping, if the patient has not been transfused in the past 3 months
  • Adsorptions, either allo- or auto- based on the patient's transfusion history
  • Transfusing antigen-negative blood depending on your facility's recommendations
Below is an example algorithm to detect Autoimmune Hemolytic Anemias (AIHA). DAT is considered the pillar in determining an AIHA diagnosis.
2. Barcellini W, and Bruno Fattizzo. The changing landscape of autoimmune hemolytic anemia. Front. Immunol., Volume 11, 2 Jun 2020, https://doi.org/10.3389/fimmu.2020.00946.

Testing algorithm for AIHA diagnosis. (2)