Is a Direct Coombs' test (Direct Antiglobulin Test) indicated in Systemic Lupus Erythematosus (SLE)?

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Last updated: February 13, 2025View editorial policy

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From the Research

Indications for Direct Coombs' Test in SLE

  • The Direct Coombs' test is indicated in Systemic Lupus Erythematosus (SLE) to diagnose autoimmune hemolytic anemia (AIHA) 1, 2.
  • A positive Direct Coombs' test in SLE patients is associated with hemolytic anemia, secondary antiphospholipid antibody syndrome, and certain autoantibodies such as anti-RNP and anti-La 1.
  • The test can also be useful in predicting high disease activity and poor renal response in SLE patients, even in the absence of hemolytic anemia 3.

Interpretation of Direct Coombs' Test Results

  • A positive Direct Coombs' test result alone is not sufficient to diagnose AIHA, and may be positive in patients without anemia or negative in some patients with AIHA 4.
  • The test result should be interpreted in conjunction with clinical findings, such as anemia, reticulocytosis, and other laboratory results 4, 5.
  • False-positive and false-negative results can occur, and pitfalls associated with the test should be considered when interpreting results 5.

Clinical Utility of Direct Coombs' Test in SLE

  • The Direct Coombs' test can be a useful biomarker for assessing disease activity and therapeutic response in SLE patients 3.
  • The test can help identify patients with SLE who are at risk of developing hemolytic anemia or other complications, and guide treatment decisions 1, 2.
  • However, the test should be used in conjunction with other diagnostic tools and clinical findings to ensure accurate diagnosis and management of SLE patients 4, 5.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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