The Direct Coombs' Test: Its Clinical Significance

doi:10.1059/0003-4819-68-1-19

The Direct Coombs' Test: Its Clinical Significance

Study in a Large University Hospital

R. F. BOHNEN, M.D.;
J. E. ULTMANN, M.D., F.A.C.P.;
J. G. GORMAN, M.D.;
M. FARHANGI, M.D.; and
J. SCUDDER, M.D., D. MED. SC.

Requests for reprints should be addressed to John E. Ultmann, M.D., Institute of Cancer Research,
99 Fort Washington Ave., New York, N. Y. 10032
.

SUMMARY

Over a 13-year period 178 patients were discovered to have a positive direct Coombs' test. A wide range of disease conditions, including collagen disorders, leukemia, lymphoma, and cancers, was found. In addition, several diseases infrequently associated with a positive direct Coombs' reaction were encountered, including pernicious anemia, ulcerative colitis, and demyelinating disorders of the central nervous system. Two patients had previously unreported findings: Coombs'-positive hemolytic anemia after amphotericin B administration and Evans' syndrome with a spontaneously occurring anti-S antibody. Cases of interest are summarized and discussed. A significant number of these patients had anemia, hepatosplenomegaly, and various serum protein abnormalities. Half of these patients had previous transfusions. The possible significance of transfusion in the production of the positive Coombs' reaction is discussed.

Article and Author Information

From the Departments of Medicine, Pathology, and Surgery, Columbia University College of Physicians and Surgeons, Presbyterian Hospital, and Francis Delafield Hospital, New York, N. Y.
This study was supported in part by research grant R10-CA-02332, National Cancer Institute, National Institutes of Health, Bethesda, Md., the Anne Winton Memorial Fund, Columbia University College of Physicians and Surgeons, the Health Research Council of the City of New York, and Abbott Laboratories, North Chicago, Ill.
Dr. Ultmann, as a Career Scientist, was supported in this work by grant I-109, the Health Research Council of the City of New York.
- Received June 16, 1967.
- Accepted September 26, 1967.