Improving the Accuracy of IMHA Diagnosis


CHF Grant 02637-A: Reducing Misdiagnosis of Immune-Mediated Hemolytic Anemia

Publication: Sun, P. L., & Jeffery, U. (2020). Effect of dilution of canine blood samples on the specificity of saline agglutination tests for immune-mediated hemolysis. Journal of Veterinary Internal Medicine

What can we learn?
Slide agglutination tests (SATs) are widely recommended for diagnosis of immune-mediated hemolytic anemia in dogs, but high false positive rates have been reported. This could unnecessarily expose a patient to the risks of immunosuppressive therapy. Investigators demonstrated that SAT specificity improved at higher dilutions (specifically a 49:1 saline-to-blood ratio).

Slide agglutination tests can achieve high specificity for the diagnosis of IMHA using a 49:1 saline-to-blood ratio. However, sensitivity at this dilution is limited, so a negative result in a dog with evidence of hemolysis merits further testing.

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