In our case there was thrombocy to penia with positive
Coombs test. Steroid such as prednisone is the initial treatment of choice for Evans syndrome.
After taking history and performing physical examination, blood tests were run for complete blood count, peripheral smear, reticulocyte count,
coombs test, serum bilirubin, mother and baby's blood group.
Important distinguishing features that may assist in diagnosing TTP in this context include the presence of schistocytes on peripheral smear, a negative
Coombs test, normal complement levels, and a low level of ADAMTS13 activity.
A positive
Coombs test requires cautious interpretation when there are no other features of autoimmune hemolytic anemia.
She was diagnosed with as autoimmune hemolytic anemia (ATHA) based on a high reticulocyte count, positive direct
Coombs test, hemoglobinuria, and low haptoglobin level, and received the conventional treatment of prednisone (2 mg/kg in divided doses) and blood transfusions.
We detected autoantibodies on the membrane of BM hemopoietic cells by bone marrow mononuclear-cell-(BMMNC-)
Coombs test [4-6] or flow cytometric analysis [7].
Other possible hemolytic anemia or enzyme deficiencies causes were excluded (negative
Coombs test, normal glucose-6-phosphate dehydrogenase enzyme level, normal hemoglobin electrophoresis and bone marrow aspiration).
Blood work revealed low haptoglobin (< 8 mg/dL), LDH was 778 U/L, retic count was 29.3%, total bilirubin was 2.4 mg/dL, direct
Coombs test was positive (warm, polyspecific IgG), and so was the indirect
Coombs test.
The patient was negative for hepatitis A, B, and C virus antibodies and antimitochondrial antibodies and had a negative direct
Coombs test result.
Diagnosis of CAHA is based on a positive direct
Coombs test in the presence of cold agglutinins.
(This would pertain providing the intended recipient has a negative atypical antibody screen and direct
Coombs test and a negative transfusion reaction history.)
The pro-thrombin time was 11.8sec, and indirect and direct
Coombs test was negative.