Garg S et al: Comparison between test for diagnosis of autoimmune haemolytic anaemia www.jrmds.in Journal of Research in Medical and Dental Science | Vol. 2 | Issue 1 | January – March 2014 92 COMPARISON BETWEEN GEL CARD AND CONVENTIONAL DIRECT COOMBS TEST FOR DIAGNOSIS OF AUTOIMMUNE HAEMOLYTIC ANAEMIA Sameep Garg*, Dhaval Mehta**, N. J. Desai ***, J.H. Vachhani**** *Resident, **Associate Professor, ***Professor, Department of Pathology, Shri M.P. Shah Govt. Medical College, Jamnagar, Gujarat, India ****Professor & Head, IHBT Dept, Shri M.P. Shah Govt. Medical College, Jamnagar, Gujarat, India DOI : 10.5455/jrmds.20142117 ABSTRACT Background: The diagnosis of autoimmune hemolytic anemia (AIHA) requires the establishment of hemolysis and demonstration of autoantibodies against red cells. Most laboratories use the conventional Coomb's test for the demonstration of the autoantibodies. However, in approximately 4-8% of the patients who present with the clinical and haematological features of AIHA, the direct agglutination test is negative on repeated testing. Attempts are therefore being made to identify a test which could be more sensitive than the conventional test, yet retaining the simplicity and cost effectiveness of the test. Aims & Objective: Comparison between Gel card and Conventional Direct Coombs Test for diagnosis of autoimmune haemolytic anemia. Material and Methods: Direct Coomb’s test done by conventional methods and Gel card methods. In the present study, the efficacy of the newly developed gel card test has been compared with the conventional Coomb's test for detection of autoantibodies in 100 cases clinically suspected to have haemolytic anemia in Guru Gobind Singh Government Hospital, Jamnagar. Results and Conclusion: The gel card picked up the antibodies in all the cases that were detected to be positive by the conventional test. In addition the gel card also picked up 2 tests which were negative by the conventional method. In view of the high sensitivity, specificity and the simplicity of the procedure this test (Gel Method) may be effectively used for diagnosis of AIHA. Key Words: Auto Immune hemolytic anemia, Direct coomb’s test, Gel Card INTRODUCTION Immune hemolytic anemia is a condition in which the life-span of red cells is shortened due to presence of a humoral antibody in the circulation that is reactive with an antigen on the red cell. Broadly the immune hemolytic anemia can be classified into alloimmune & autoimmune [1]. In certain diseases or conditions an individual's blood may contain IgG antibodies that can specifically bind to antigens on the red blood cell (RBC) surface membrane, and their circulating red blood cells (RBCs) can become coated with IgG alloantibody and/or IgG autoantibodies. Complement proteins may subsequently bind to the bound antibodies. The Coombs test is used to detect these antibodies or complement proteins that are bound to the surface of red blood cells. Both IgM and IgG antibodies bind strongly with their antigens. IgG antibodies are most reactive at 37°C. IgM antibodies are easily detected in saline at room temperature as IgM antibodies are able to bridge between RBC’s owing to their large size, efficiently creating what is seen as agglutination. IgG antibodies are smaller and require assistance to bridge well enough to form a visual agglutination reaction. Reagents used to enhance IgG detection are referred to as potentiators. RBCs have a net negative Original Article