The Direct Coombs' Test: Its Clinical Significance

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Abstract
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 were found. In addition, several patients with 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 following amphotericin B administration and Evans'' syndrome with a spontaneously occurring anti-S antibody. Cases of interest were 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 was discussed.