The Coombs test looks for
Direct antiglobulin test; Indirect antiglobulin test; Anemia - hemolytic
How the Test is Performed
How to Prepare for the Test
No special preparation is necessary for this test.
How the Test will Feel
When the needle is inserted to draw blood, some people feel moderate pain. Others feel only a prick or stinging. Afterward, there may be some throbbing or slight bruising. This soon goes away.
Why the Test is Performed
There are two types of the Coombs test:
The direct Coombs test is used to detect antibodies that are stuck to the surface of red blood cells. Many diseases and drugs can cause this to happen. These antibodies sometimes destroy red blood cells and cause
The indirect Coombs test looks for antibodies that are floating in the blood. These antibodies could act against certain red blood cells. This test is most often done to determine if you may have a reaction to a blood transfusion.
A normal result is called a negative result. It means there was no clumping of cells and you have no antibodies to red blood cells.
Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your provider about the meaning of your specific test results.
What Abnormal Results Mean
An abnormal (positive) direct Coombs test means you have antibodies that act against your red blood cells. This may be due to:
hemolytic anemia Chronic lymphocytic leukemiaor similar disorder
Blood disease in newborns called
erythroblastosis fetalis(also called hemolytic disease of the newborn) Infectious mononucleosis
- Mycoplasma infection
Systemic lupus erythematosus Transfusion reaction, such as one due to improperly matched units of blood
The test result may also be abnormal without any clear cause, especially among the older people.
An abnormal (positive) indirect Coombs test means you have antibodies that will act against red blood cells that your body views as foreign. This may suggest:
- Erythroblastosis fetalis
- Incompatible blood match (when used in blood banks)
There is little risk involved with having your blood taken. Veins and arteries vary in size from one person to another and from one side of the body to the other. Taking blood from some people may be more difficult than from others.
Other risks associated with having blood drawn are slight, but may include:
Faintingor feeling lightheaded
- Multiple punctures to locate veins
Hematoma(blood buildup under the skin)
- Excessive bleeding
- Infection (a slight risk any time the skin is broken)
Elghetany MT, Banki K. Erythrocytic disorders. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 24th ed. Philadelphia, PA: Elsevier; 2022:chap 33.
Michel M. Autoimmune and intravascular hemolytic anemias. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 151.
Review Date: 01/25/2022
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