ISSN 2997-1036
International Journal of Hematology | Vol. 1, No. 10, October 2010 | pp. 73–80
DOI: 10.46882/2010/IJH/000010
Original Article
Title: Comparative analysis of direct antiglobulin test positivity in autoimmune versus drug-induced hemolytic anemias
Names of Authors: M. N. Abubakar¹, N. O. Usman², P. Q. Sadiq³
Authors’ Affiliations: ²Department of Haematology, University of Maiduguri Teaching Hospital, Maiduguri, Nigeria; ²Department of Clinical Pharmacology, Ahmadu Bello University, Zaria, Nigeria; ³Department of Pathology, Aminu Kano Teaching Hospital, Kano, Nigeria
Abstract: Immune-mediated hemolytic anemias present diagnostic challenges when differentiating idiopathic autoimmune origins from exposure-related drug etiologies. A retrospective analysis was performed on 84 positive direct antiglobulin test cases over a 3-year institutional archive review. Autoimmune hemolytic anemia accounted for 64 cases (76.2%), while drug-induced etiologies (linked to methyldopa, cephalosporins, and penicillins) accounted for 20 cases (23.8%). Serological characterization showed complement-only (C3d) positivity in 31.2% of autoimmune cases, whereas warm IgG reacting alone appeared in 45.3%. Drug-induced cases displayed immune complex or drug-adsorption patterns with panagglutination features in 70% of eluate assays. Hemolysis markers revealed higher mean total bilirubin (4.8 ± 1.2 mg/dl versus 2.6 ± 0.9 mg/dl) and lower haptoglobin levels in autoimmune cohorts compared to drug-associated cases. Discontinuation of implicated pharmaceuticals resolved hemolysis within 14 days in all drug-induced patients without prolonged steroid therapy. Thorough drug history integration remains essential for accurate classification and avoiding overtreatment.
Keywords: Direct antiglobulin test, autoimmune hemolytic anemia, drug-induced hemolytic anemia, eluate, hemolysis
Manuscript Timeline: Received: July 20, 2010; Revised: August 25, 2010; Accepted: September 12, 2010; Published: October 13, 2010