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Research ArticleResearch and Reports

Strength of Direct Antiglobulin Test as an Indicator of Disease Severity in Autoimmune Hemolytic Anemia

Hervé Nyenti, Rajkumar Rajendran, Julie Soder, Carol A. Carman and Juan U. Rojo
American Society for Clinical Laboratory Science April 2024, 37 (2) 24-29; DOI: https://doi.org/10.29074/ascls.2023003227
Hervé Nyenti
University of Texas Medical Branch
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Rajkumar Rajendran
University of Texas Medical Branch
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Julie Soder
University of Texas Medical Branch
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Carol A. Carman
University of Texas Medical Branch
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Juan U. Rojo
University of Texas Medical Branch
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  • Article
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Article Figures & Data

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    Figure 1.

    AIHA cases by age group older than 11 years old.

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    Table 1.

    AIHA severity score

    LDH1Hemoglobin1Severity Score
    >600<72
    >600≥71
    ≤600<71
    ≤600≥70
    • ↵1 Lactate dehydrogenase (LDH) abnormal when >600 IU/L. Hemoglobin is critical when <7 g/dL.

    • View popup
    Table 2.

    AIHA cases by race and ethnicity

    n%
    Caucasian/White Hispanic/Latino16847.3
    Black or African American10228.7
    Caucasian/White not Hispanic/Latino6819.2
    Asian164.5
    American Indian or Alaskan Native10.3
    Total355100
    • View popup
    Table 3.

    AIHA cases by age group

    Age Groupn%%*
    0–10 years24268.2/
    11–20 years113.19.7
    21–30 years185.115.9
    31–40 years92.57.9
    41–50 years164.514.2
    51–60 years154.213.3
    61–70 years236.520.4
    71–80 years123.410.6
    81–90 years61.75.3
    91–100 years30.82.6
    Total355100100
    • ↵* Represents percentages of age groups older than 11 years old.

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    Table 4.

    AIHA cases by sex

    Sexn%
    Female19053.5
    Male16546.5
    Total355100
    • View popup
    Table 5.

    Correlation between DAT and LDH, hemoglobin, and severity

    LDHHemoglobinSeverity
    Spearman’s rhoDAT polyspecificCorrelation coefficient0.028−0.3450.364
    Significance (2-tailed).803<.001*<.001*
    n809595
    DAT IgGCorrelation coefficient−0.11−0.2800.253
    Significance (2-tailed).924.005*.012
    n809898
    DAT C3Correlation coefficient−0.148−0.3610.326
    Significance (2-tailed)0.191<.001*.001*
    n809595
    • ↵* P < .01.

    • View popup
    Table 6.

    Correlation between age and AIHA severity

    Severity
    AgePearson correlation0.441
    Significance (2 tailed)<.001*
    N98
    • ↵* P < .01.

    • View popup
    Table 7.

    AIHA severity by race, sex, and ethnicity

    Severity
    012TotalPercentEta(η)Eta2(η2)
    RaceBlack/African American21272121.4%0.0870.008
    Caucasian/White2129277778.6%
    SexFemale1425185758%0.0660.004
    Male916164142%
    EthnicityHispanic/Latino151393738%0.3000.09
    Not Hispanic/Latino828246061%
    Unknown00110.01%
    AIHA typeCold0551010.2%0.3300.11
    Mixed513173535.7%
    Unspecified71442525.5%
    Warm11982828.6%

    Where η2 = 0.01 indicates small effect. η2 = 0.06 indicates medium effect. η2 = 0.14 indicates large effect.

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    American Society for Clinical Laboratory Science: 37 (2)
    American Society for Clinical Laboratory Science
    Vol. 37, Issue 2
    1 Apr 2024
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    Strength of Direct Antiglobulin Test as an Indicator of Disease Severity in Autoimmune Hemolytic Anemia
    Hervé Nyenti, Rajkumar Rajendran, Julie Soder, Carol A. Carman, Juan U. Rojo
    American Society for Clinical Laboratory Science Apr 2024, 37 (2) 24-29; DOI: 10.29074/ascls.2023003227

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    Strength of Direct Antiglobulin Test as an Indicator of Disease Severity in Autoimmune Hemolytic Anemia
    Hervé Nyenti, Rajkumar Rajendran, Julie Soder, Carol A. Carman, Juan U. Rojo
    American Society for Clinical Laboratory Science Apr 2024, 37 (2) 24-29; DOI: 10.29074/ascls.2023003227
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    Keywords

    • AIHA - autoimmune hemolytic anemia
    • DAT - direct antiglobulin test
    • Hb - hemoglobin
    • ICD - International Classification of Diseases
    • LDH - lactate dehydrogenase
    • RBC - red blood cell
    • wAIHA - warm autoimmune hemolytic anemia
    • direct antiglobulin test (DAT)
    • autoimmune hemolytic anemia (AIHA)
    • hemoglobin (Hb)
    • lactate dehydrogenase (LDH)
    • epidemiology
    • disease severity
    • autoimmunity

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