Performance of 2 microtiter canine Coombs' tests
Performance of 2 microtiter canine Coombs' tests
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DOI：
10.1111/j.1939-165x.2007.tb00205.x
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发表时间：
2007-06-01
影响因子：
1.2
通讯作者：
Borjesson, Dori L.
中科院分区：
文献类型：
--
作者：
Overmann, Jed A.;Sharkey, Leslie C.;Borjesson, Dori L.
背景：Coombs试验检测红细胞表面的免疫球蛋白或补体，长期以来一直是实验室确认免疫介导的溶血性贫血（IMHA）的标准，IMHA是犬溶血性贫血的常见原因。然而，这种测试的灵敏度相对较低。优化检测灵敏度可以减少实验室结果与临床诊断之间的差异，并在某些情况下及时制定适当的治疗方案。目的：本研究的目的是1)表征2种犬库姆斯试验检测IMHA的敏感性和特异性，2)记录使用超过制造商指示的多种稀释抗血清的效果，3)评估在测试方案中使用单价抗血清的必要性。方法：对65份犬全血标本进行Coombs检验。根据一套预先确定的标准，将患者分为IMHA阳性或阴性。将IMHA分类与适用于微量滴度板格式的2种不同Coombs试验的Coombs试验结果进行比较。一个Coombs试验（VMRD Coombs试验）使用单一多价抗血清（VMRD, Inc, Pullman， WA， USA），而第二个Coombs试验（明尼苏达大学[U of MN] Coombs试验）同时使用多价和单价抗血清。结果：VMRD Coombs试验的敏感性为61%，特异性为100%，U of MN Coombs试验的敏感性为82%，特异性为95%。使用多种抗血清稀释剂导致另外6例Coombs阳性检测结果。所有阳性的Coombs试验结果均为多价抗血清阳性。结论：与VMRD Coombs试验相比，在微量滴度板中使用U of MN Coombs试验对犬患者的IMHA检测更为敏感。多种抗血清稀释剂的使用增加了检测灵敏度。然而，在Coombs试验方案中使用单价抗血清并没有增加敏感性。
Background: The Coombs' test, which detects immunoglobulin or complement on RBC surfaces, has long been the standard for laboratory confirmation of immune-mediated hemolytic anemia (IMHA), a common cause of hemolytic anemia in the dog. This test, however, suffers from relatively low sensitivity. Optimization of test sensitivity would lead to fewer discrepancies between laboratory results and clinical diagnoses, and in some cases institution of appropriate therapy in a timely manner. Objectives: The objectives of this study were to 1) characterize the sensitivity and specificity of 2 canine Coombs' tests for the detection of IMHA, 2) document the efficacy of using multiple antisera dilutions beyond what is directed by manufacturers, and 3) evaluate the necessity of monovalent antisera in the test protocol. Methods: Sixty- five canine whole-blood samples submitted for Coombs' testing were evaluated. Patients were classified as IMHA positive or negative based on a set of predetermined criteria. IMHA classification was compared to Coombs' test results from 2 different Coombs' tests adapted to a microtiter-plate format. One Coombs' test (VMRD Coombs' test) utilized a single polyvalent antiserum (VMRD, Inc, Pullman, WA, USA), while a second Coombs' test (University of Minnesota [U of MN] Coombs' test) used both polyvalent and monovalent antisera. Results: Sensitivity and specificity were 61% and 100% for the VMRD Coombs' test, and 82% and 95% for the U of MN Coombs' test. The use of multiple antisera dilutions resulted in 6 additional Coombs' positive test results. All positive Coombs' test results were positive by polyvalent antisera. Conclusions: When used in a microtiter-plate format, the U of MN Coombs' test was a more sensitive test for the detection of IMHA in canine patients when compared to the VMRD Coombs' test. The use of multiple antisera dilutions increased test sensitivity. Sensitivity, however, was not increased by the use of monovalent antisera in the Coombs' test protocol.