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Samwel Mikaye: Understanding Direct and Indirect Coombs Testing in Diagnosing Immune-Mediated Hemolysis
Samwel Mikaye/LinkedIn
Mar 2, 2026, 16:01

Samwel Mikaye: Understanding Direct and Indirect Coombs Testing in Diagnosing Immune-Mediated Hemolysis

Samwel Mikaye, Medical Doctor at MSK, shared a post on LinkedIn:

“Coombs Test (Antiglobulin Test)

The Coombs test detects antibodies or complement proteins bound to red blood cells (RBCs), helping diagnose immune-mediated hemolysis.

There are two main types: Direct and Indirect.

1. Direct Coombs Test (DAT)

Purpose: Detects antibodies already attached to the patient’s RBCs.

Principle

  • Patient RBCs are washed and incubated with Coombs reagent (anti-human globulin).
  • If RBCs are coated with IgG or complement, the reagent causes agglutination.

Clinical Uses

  • Autoimmune hemolytic anemia (AIHA)
  • Warm antibody type (IgG)
  • Cold antibody type (IgM/complement)
  • Hemolytic disease of the newborn (HDN)
  • Mother’s antibodies attack fetal RBCsDrug-induced hemolysis

2. Indirect Coombs Test (IAT)

Purpose: Detects antibodies in the patient’s serum that can bind to RBCs.

Principle

  • Patient serum is incubated with RBCs of known antigen type.
  • Coombs reagent is added – agglutination indicates presence of antibodies.

Clinical Uses

  • Pre-transfusion testing (detecting incompatible antibodies)
  • Prenatal testing for Rh incompatibility (maternal anti-D antibodies)”

Samwel Mikaye: Understanding Direct and Indirect Coombs Testing in Diagnosing Immune-Mediated Hemolysis

Other posts  featuring Samwel Mikaye on Hemostasis Today.

Coombs Test Direct Coombs Test Health Hematology hemolysis Hemostasis News Hemostasis Today immune-mediated hemolysis Indirect Coombs Test Medicine Prenatal Care Samwel Mikaye
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