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What is the Coombs Test?

Coombs tests are antiglobulin tests or RBC antibody tests that look for antibodies targeting the red blood cells in your blood. Antibodies are part of the immune system. They combat infections but sometimes mistakenly attack your healthy cells.

There are some antibodies associated with your blood type. Each individual’s red blood cells are unique. If your immune system discovers antibodies that do not match yours, it will produce them.

There are two kinds of Coombs tests. The direct test checks for antibodies in RBCs. The indirect test checks for antibodies in your blood’s serum.

 

What is the Coombs Test used for?

The uses of the Coombs test include looking for antibodies on the red blood cell surfaces. These antibodies indicate hemolytic anemia, a condition in which your blood lacks red blood cells due to their early destruction. A normal red blood cell has a lifespan of around 120 days; however, it destroys the red blood cells much before the 120-day mark in patients with hemolytic anemia. 

Understanding the test results of the Coombs Test

The Coombs test identifies the red blood cell agglutination. It indicates that it has detected no antibodies or that the number of antibodies detected was likely insignificant. If there is no clump found, the test is negative.

Positive and negative results on the DAT and IAT tests have different meanings. The agglutination of the red blood cells gives positive results during the test.

 

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Frequently Asked Questions:

Why do I need the Coombs test?

The Coombs test determines if the blood contains certain kinds of antibodies. If the immune system detects something incorrectly, it may sometimes produce antibodies against cells. Coombs test is used to see if you have antibodies in your blood that are causing your immune system to attack and kill your red blood cells. If this happens, you may develop hemolytic anemia.

What happens during the Coombs Test?

Perform the direct Coombs test on a red blood cell sample. It identifies antibodies present in the circulation that may attach to specific red blood cells, posing complications in blood mixing. It can detect antibodies already bound to red blood cells.

 

What are direct and indirect Coombs tests?

Coombs tests are of two types – direct and indirect. Coombs test, or direct antiglobulin test, is the most often used method for diagnosing hemolytic anemia. The indirect Coombs test is exclusively used in pregnant women's prenatal and blood transfusion testing. Blood is collected from an arm vein and washed to collect red blood cells for the direct Coombs test.

Why is the Coombs test done during pregnancy?

At your first prenatal appointment, your blood examination is conducted to see whether you were ever sensitized to Rh-positive blood. During early pregnancy, all women have an indirect Coombs test. If you are Rh-negative and your test results indicate that you are not sensitized, perform a second test between 24 and 28 weeks.

What does Coombs positive mean for the baby?

When a Coombs test result is positive, two major complications in babies are anemia and jaundice. The confusing thing is that only a tiny percentage of Coombs positive newborns will acquire these difficulties, whereas some Coombs negative babies may get them. Thus, a positive test indicates that monitoring for anemia and jaundice is more crucial than determining which babies need treatment.

What does the Coombs test measure?

  • Direct Coombs test

The direct Coombs test looks for antibodies in RBCs. Your body may produce antibodies in response to the disease, or it may have been acquired via a blood transfusion.

  • Indirect Coombs test

The indirect Coombs test detects antibodies in the liquid component of your blood. Antibodies can attack red blood cells, but they do not attach to them.

How should I prepare for the test?

Before visiting the pathology lab, your doctor will instruct you to drink water. Certain drugs may need to be stopped before the test, but only if your doctor directs you to do so.

You may experience minor discomfort or a pinching sensation during the test when drawing blood. However, this is normal for a brief period and is relatively little.

Following the removal of the needle, you may have a throbbing sensation in the injected area. You must apply pressure to the site where the needle was injected.

 

Is the test painful and risky?

If your doctor verifies that you have a low RBC count, they may prescribe the Coombs test to determine the kind of anemia you have. The following are a few rare side effects:

  • Dizziness or fainting
  • Hematoma, a blood-filled pocket under the skin
  • Infection is avoided by thoroughly cleansing the skin before inserting the needle
  • Uncontrollable bleeding

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