Required section · Section 6 of 6
Keep the conclusion proportional
This case supports increased red-cell destruction with an intravascular component and morphology and DAT findings that warrant immune follow-up. It does not establish autoimmune hemolytic anemia, a complement-mediated disorder, a membrane defect, an enzyme deficiency, paroxysmal nocturnal hemoglobinuria (PNH), or thrombotic microangiopathy. Qualified clinical and specialized laboratory review remain necessary.
For an unresolved possible PNH pattern, refer to the qualified hematopathology or reference-laboratory pathway for validated PNH flow-cytometry interpretation.
Method and policy details change the action: validated analyzer and reagent, local intervals, hemolysis-index thresholds, DAT algorithm, controls, and referral criteria belong in the local procedure. CLIA requires applicable performance specifications and written procedures for calibrators, controls, calibration, reportable range, and corrective action. Use the validated local procedure for release, comments, redraw decisions, and referral.
| Clue | Bounded laboratory action | Limit |
|---|---|---|
| IgG DAT with hemolysis pattern | Qualified immunohematology review | DAT does not establish immune hemolysis |
| Bite cells | Qualified enzyme-testing review | Does not diagnose enzyme deficiency |
| Sickle cells | Hemoglobin testing review | Morphology alone is insufficient |
| Unexplained hemolysis, negative DAT | Local repeat or reference DAT pathway | Routine DAT can miss coating |
| Possible PNH pattern | Validated specialized flow referral | Needs clinical correlation |
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