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The Direct Coombs Test and Heat Elution Test in ABO Incompatible Hemolytic Disease of the Newborn.

Journal of the Korean Pediatric Society 1988;31(12):1633-1640.
Published online December 31, 1988.
The Direct Coombs Test and Heat Elution Test in ABO Incompatible Hemolytic Disease of the Newborn.
Kook In PArk, Chul Lee, Ran Namgung, Dong Gwan Han, Kir Young Kim
Department of Pediatrics, Yonsei University, College of Medicine, Seoul, Korea
ABO형 부적합 신생아 용혈성질환에서 직접 Coombs 검사와 가열(Heat) Elution 검사
박국인, 이철, 남궁란, 한동관, 김길영
연세대학교 의과대학 소아과학교실
Received: 13 May 1988   • Accepted: 6 August 1988
Abstract
The clinical study on 28 cases of ABO HDN who were diagnosed at Pediatric Department of Severance hospital and Yong Dong Severance hospital, Yonsei University for last 5 months was. And in these cases, heat elution test in combined with direct Coombs test using standard techniques were performed to evaluate the clinical significance of serological diagnosis. The following results were obtained. 1) Of 28 ABO HDN 13(46.4%) were AO blood type and 15(53.6%) were BO blood type. 2) The first bom occupied 57.1% of ABO HDN, three quarters having positive family history. 3) The apperarance of jaundice was almost within 2-3 days of life, about one half in the first 24 hours of life. 4) The hyperbilirubinemia in most cases of ABO HDN was treated with phototherapy and only 2 cases received exchange transfusion. 5) There is no significant difference in clinical severity between A and B group infants in ABO HDN. 6) Direct Coombs test positive rate was 7.1% and immune antibodies on their red cells were demonstrable in 11 cases (39.3%) under heat elution test. 7) The infants of ABO incompatible group had significantly higher maximum bilirubin and lower capillary hemoglobin concentration than thoses of control group. 8) The infants in whom no antibodies were demonstrable on the red cells or in the red cell eluates also had significantly higher maximum bilirubin and lower capillary hemoglobin levels than the ABO compatible group. Inconlusion, heat elution test in coordination with direct Coombs test in ABO HDN had proved to be routinely applicable, accurate in identifying the ABO antibodies, and highly sensitive and specific for the serological diagnosis.
Key Words: ABO Hemolytic Disease of the Newborn (ABO HDN), Coombs Test, Heat Elution Test.


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