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December 8, 2025BloodOpen Access

Autoimmune hemolytic anemia with an initially negative direct antiglobulin test: A diagnostic challenge

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Authors

SSSandhya SrinivasaCHCristina Hamacher

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Overview

Case report reveals autoimmune hemolytic anemia in a man with negative direct antiglobulin test, indicating diagnostic challenges.

Key Points

  • This report discusses the challenges in diagnosing autoimmune hemolytic anemia (AIHA) with an initially negative direct antiglobulin test.
  • Case report of a 41-year-old man with symptoms consistent with hemolytic anemia.
  • Initial laboratory tests included hemoglobin, bilirubin, LDH, haptoglobin, and reticulocyte index.
  • Repeat direct antiglobulin test was performed after strong clinical suspicion.
  • Patient presented with jaundice, dark urine, and weakness, with lab findings indicating hemolytic anemia.
  • Initial direct antiglobulin test was negative, but repeat testing revealed IgG antibodies consistent with warm AIHA.
  • Following diagnosis, patient was treated with corticosteroids and showed clinical improvement.

Cite This Study

Srinivasa et al. (2025) studied this question.

synapsesocial.com/papers/693624dd4fa91c937236d191https://doi.org/10.1182/blood-2025-6447
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Also Consider

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  1. 1Warm autoimmune hemolytic anemia following epstein-barr virus reactivation: An uncommon clinical association2025
  2. 2A Case Report of a 14-year-old Boy with Mixed-type Autoimmune Hemolytic Anemia2025
  3. 3Severe Warm Autoimmune Hemolytic Anemia With Profound Anemia Requiring Multimodal Immunosuppressive Therapy2026
  4. 4Autoimmune hemolytic anemia (AIHA) associated with human immunodeficiency virus (HIV) infection: Two challenging cases2025
  5. 5Mixed autoimmune hemolytic anemia as a rare initial presentation of systemic lupus erythematosus2025