Abstract
The Donath-Landsteiner (DL) test is a serologic test used to detect the presence of a biphasic hemolysin. This autoantibody is seen in patients with paroxysmal cold hemoglobinuria. The test relies on the characteristic cold binding of an IgG autoantibody with specificity to the P blood group antigen. This autoantibody causes complement-mediated red blood cell (RBC) lysis when warmed to body temperature. In this review, we describe the various methods for performing the DL test-namely a direct test, an indirect test, an indirect test with modifications such as the use of enzyme-treated RBCs and two stages, and an indirect antiglobulin DL test-and highlight the advantages and disadvantages of each. Our focus is on the indirect testing method as it is most commonly used in blood bank laboratories.
Highlights
Procedure Summary The procedural method for the DL test suggested by the AABB is the described indirect DL test.[5]
Preanalytical analysis of hemolysis should be taken into account, and special care should be taken to avoid hemolysis during the collection process
The DL test is the diagnostic assay for detecting the presence of a biphasic hemolysin
Summary
The Donath-Landsteiner (DL) test is a serologic test used to detect the presence of a biphasic hemolysin This autoantibody is seen in patients with paroxysmal cold hemoglobinuria. The test relies on the characteristic cold binding of an IgG autoantibody with specificity to the P blood group antigen This autoantibody causes complement-mediated red blood cell (RBC) lysis when warmed to body temperature. The Donath-Landsteiner (DL) test is a serologic test used to detect the presence of a biphasic hemolysin, seen in patients with paroxysmal cold hemoglobinuria (PCH). The test relies on the characteristic cold binding of an IgG autoantibody with specificity to the P blood group antigen, which causes complement-mediated red blood cell (RBC) lysis when warmed to body temperature. The patient’s RBC sample should have a positive DAT due to C3 only and no demonstrable autoantibody activity by routine methods
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