Automatic laboratory-initiated reflex testing to identify patients with autoimmune hemolytic anemia

Paul Froom*, Alexander Neck, Michaela Shir, Rosa Haavis, Mira Barak

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

The clinical usefulness of automatic laboratory-initiated testing of patients with recent-onset normocytic anemia to diagnose autoimmune hemolytic anemia (AIHA) is uncertain. During a 28-month period, we performed 784,185 CBC counts. Patients without a history of anemia had reticulocyte count testing if hemoglobin values were less than 10 g/dL (<100 g/L) and mean corpuscular volume was 80 μm3 (80 fL) or more. A direct antiglobulin test (DAT) was performed if the uncorrected reticulocyte count was 2% or more of the RBCs (≥0.02). Of 784,185 CBC counts, 3,841 (0.49%) revealed recent-onset normocytic anemia, 424 (11.04%) with reticulocyte counts of 2% (0.02) or more. Of those with elevated reticulocytes counts, 52 (12.3%) had positive DAT results. Patient information was available for 40 patients. Physicians were unaware of the existence of AIHA in 33 (83%) of them. Of the 40 patients, 11 (28%) were treated with steroids and 6 (15%) were hospitalized; in 2 patients (5%), medications were stopped because they were suspected to have caused the hemolytic anemia. Automatic laboratory testing for patients with recent-onset normocytic anemia ensures recommended practices, probably saves physician visits, and, for some patients, results in more timely diagnosis and appropriate treatment.

Original languageEnglish
Pages (from-to)129-132
Number of pages4
JournalAmerican Journal of Clinical Pathology
Volume124
Issue number1
DOIs
StatePublished - Jul 2005
Externally publishedYes

Keywords

  • Anemia
  • Laboratory
  • Normocytic
  • Workup

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