shortness of breath, cold hands and feet, and very pale skin, you may have an insufficient amount of red blood cells. This condition is called anemia, and there are many causes. If it’s confirmed that you have a low red blood cell count, the Coomb's test is one of the blood tests that your doctor may order to help find out what kind of anemia you have.
Why Is the Coombs Test Done?
The Coomb's test checks the blood to see if it contains certain antibodies. Antibodies are proteins that your immune system makes when it detects that something may be harmful to your health. These antibodies will destroy the harmful invader. If the immune system’s detection is wrong, it will make antibodies that don’t destroy the invader. This can cause many kinds of health problems.
The Coomb's test will help your doctor determine if you have antibodies in your bloodstream that are causing your immune system to attack and destroy your own red blood cells. If your red blood cells are being destroyed, this can result in a condition called hemolytic anemia.
There are two types of Coomb's tests: the direct Coomb's test and the indirect Coomb's test. The direct test is more common and checks for antibodies that are attached to the surface of your red blood cells. The indirect test checks for unattached antibodies that are floating in the bloodstream. It is also administered to determine if there was a potential bad reaction to a blood transfusion.
What Are the Results for the Coombs Test?
Normal Results
Results are considered normal if there is no clumping of red blood cells.
Abnormal Results in a Direct Coombs Test
It’s an abnormal result if there is clumping of the red blood cells during the test. Clumping (agglutination) of your blood cells during a direct Coombs test means that you have antibodies on the red blood cells and that you may have a condition that causes the destruction of red blood cells by your immune system (hemolysis). The conditions that may cause you to have antibodies on red blood cells are:
>autoimmune hemolytic anemia (your immune system reacts to your red blood cells)
>drug toxicity where you develop antibodies to your red blood cells; drugs that can cause this include cephalosporins (an antibiotic), levodopa (for Parkinson’s disease), dapsone (antibacterial), nitrofurantoin (antibiotic), NSAIDs such as ibuprofen, and quinidine (heart medication)
>transfusion reaction where your immune system attacks donated blood.
>different blood types between mother and infant (erythroblastosis fetalis)
>chronic lymphocytic leukemia and some other leukemias
>lupus (systemic lupus erythematosus), an autoimmune disease
>mononucleosis
>infection with mycoplasma (a type of bacteria that many antibiotics can’t kill)
>syphilis
>Sometimes, especially in older adults, a Coombs test will have an abnormal result even without any other disease or risk factors.
Abnormal Results in an Indirect Coombs Test
An abnormal result to an indirect Coombs test means you have antibodies circulating in your bloodstream that could cause your immune system to react to any red blood cells that are considered foreign to the body, particularly regarding those that may be present during a blood transfusion. Depending on your age and circumstances, this could mean a mother and infant have different blood types (erythroblastosis fetalis), an incompatible blood match for a blood transfusion, or hemolytic anemia due to an autoimmune reaction or drug toxicity.
Infants with erythroblastosis fetalis may have very high levels of bilirubin in their blood, which leads to jaundice. This reaction occurs when the infant and mother have different blood types (Rh factor positive or negative, or ABO type differences), and the mother’s immune system attacks the baby’s blood during labor. This condition must be watched carefully because it can result in death of the mother and child. A pregnant woman is often given an indirect Coombs test to check for antibodies during prenatal care, before labor.
