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Advanced aspects not covered (or not covered in detail)
Low ionic strength saline (LISS) incubation
Temperature of incubation
Cold and walm antibodies
IgG and IgM antibodies
Anti I and anti i
Monoclonal Coombs reagent
Serological titration
Transfusion serology
Blood grouping with LISS or with enzyme treated RBCs
A mnemonic has been suggested
A memory device to remember that the DAT tests the RBCs and is used to test infants for haemolytic disease of the newborn is: Rh Disease; R = RBCs, D = DAT.
Following is a copy & paste from my talk page:
Overall your diagram of the Coombs test is good. I may be mistaken, as it has been some time since I worked in blood transfusion, but one situation may not covered in your diagram. This is when the patient's RBCs are used in the indirect Coombs test with serums of known type. We always did blood groups with the indirect Coombs test by using both the patients cells (against known serums) and the patients serum (against known cells) to double check the methods and to find very weak antibodies or antigens that were not fully expressed. Your diagram only covers screening for serum antibodies in the indirect test and not screening for RBC antigens. It may be better not to specify "donor" and "recipient" in your diagram for the indirect Coombs test portion. Snowman 19:20, 16 February 2006 (UTC)
There is plenty of time to do the Wiki page, so no need to rush it. I think that there may be one or two other minor points to put right too, which I hope to list in the next few days.
Will it work by using "test cells" and "test serum" with foot notes? If the article page is not clear, please indicate which part needs clarification? Snowman 18:02, 20 February 2006 (UTC)
The form of the Coombs test may not be specified but it is usually clear from the clinical context or why the test was requested by a physician that the direct or indirect form is referred to.
I understand what you are getting at here but it is a little ambiguous. Is it really needed?-- Ennaear 10:21, 27 July 2006 (UTC)
I removed the gel electrophoresis reference. The gel technology used for AHG testing is actually a small chamber filled with polyacrylamide gel. The gel traps agglutinated RBC's at the top, allowing non-agglutinated RBC's to flow freely to the bottom upon centrifugation. I am unaware of gel electrophoresis use in this context. Thanks!-- Ennaear 07:46, 28 July 2006 (UTC)
Does anyone have any photographs of agglutination? Perhaps photographs of the gross appearance of agglutination or the microscopic appearance. Snowman 15:05, 28 July 2006 (UTC)
I made a few minor grammatical fixes (mostly apostrophes) and added a sentence to the opening paragraph describing the most common clinical uses of the Coombs test. Also removed the sentence "A Coombs test is requested by a physician when it is thought that the result will advance knowledge of a patients illness" - as it seems this is true of any medical test. MastCell 17:43, 10 August 2006 (UTC)
I took off the "Expand" stub... this article seems pretty expanded. MastCell 22:22, 11 August 2006 (UTC)
Some of the links are said to be double interwiki. What is this? Snowman 14:28, 4 December 2006 (UTC)
I think I'm at least average and I couldn't follow this article because it uses so much unexplained language. I tried to start to fix things but there's just to much. For example I figure RBCs means Red blood cells but what's RBC's mean. Its worse than a visit to the doctor's office. -- Droll 06:49, 14 December 2006 (UTC)
I think they should be just called erythrocytes instead of RBCs, which feels like the usual medical slang (use and abude of cryptic acronyms that make texts unreadable instead of scientific terms understood by biologists and normal people with some degree of education). If you are writing lab results write RBC, if you are writing a text use words. — Preceding unsigned comment added by 84.55.196.197 ( talk) 15:10, 15 March 2014 (UTC)
It says in the article that blood can be taken by a phlebotomist, nurse or physician. Is my medical school unusual in letting students take blood ;) Joncomelately Come over 22:48, 28 December 2006 (UTC)
Consider the following paragraph:
"The direct Coombs test is used to detect red blood cells sensitized with IgG alloantibody, IgG autoantibody, and complement proteins. It detects antibodies bound to the surface of red blood cells in vivo. The red blood cells (RBCs) are washed (removing the patient's own plasma) and then incubated with antihuman globulin (also known as "Coombs reagent"). If this produces agglutination of the RBCs, the direct Coombs test is positive."
I think it's inappropriate to say that RBCs get sensitized by antibodies, rather it's the other way round, meaning, RBCs can sensitize some component of the immune system leading to production of IgM/IgG that gets bound to the RBC surface. Since, it'd be fairly complex to express this principle, and somewhat even beyond the scope of this article, I suggest the following alternative to the above paragraph"
The direct Coombs test is used to detect antibodies or complement proteins bound to the surface of red blood cells in vivo. The antibodies could be IgG allo- or autoantibodies. The red blood cells (RBCs) are washed (removing the patient's own plasma) and then incubated with antihuman globulin (also known as "Coombs reagent"). If this produces agglutination of the RBCs, the direct Coombs test is positive.
Or more simply, sensitized with could be substituted by primed with.
Do let me know what you all think.
Ketan Panchal, MBBS ( talk) 08:48, 2 May 2008 (UTC)
It is the lead and it needs to be clear:
The changes are most satisfactory. Thanks for your prompt attention. Ketan Panchal, MBBS ( talk) 13:29, 2 May 2008 (UTC)
Thanks in advance.
Ketan Panchal, MBBS ( talk) 09:51, 2 May 2008 (UTC)
Washing of RBC's is simple and most lab's have a cell washer. Simply, one drop of a 3 to 5% solution of the patient's red cells are placed in a tube. The tube is filled at least half way with normal saline. The tube is then centrifuged. The saline is decanted leaving only the cell button. Suspend the cell button and repeat the process three more time.
DAT's are not usually included in a routine Type and Screen any more. Also I find some of the wording in the article as a whole archaic. Very few Blood Banks use serum for testing, plasma is used exclusivly. There is also a step missing from the explaination of Coombs testing. After the patients RBCs are washed Antihuman globulin is added, there is no incubation period. If the test is positive at this point the testing if finished. If however the test is negative, another reagent is added, this is the Coombs reagent or check cells. They are sensitized red cells to ensure the antihuman globulin has been added. Cross matching is not really an indirect coombs, thats streaching it a bit too far. I know this discussion is old, but I wanted to add my two cents. If anything I have included is confusing let me know. Quazar03 ( talk) 03:51, 5 April 2012 (UTC)
i've redirected Antiglobulin test here, since it even stated that it meant the same thing. People working on this article, Coombs test, might wish to check the previous version of Antiglobulin test in case there is any info there that is not included here. The stub was very short so someone working on this article should be able to do it quickly. Boud ( talk) 20:17, 15 June 2011 (UTC)
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