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Antiglobulin (Coombs) test

Definition

A two-stage assay that detects IgG antibodies bound to red blood cells. The direct test detects in-vivo cell-bound IgG; the indirect test detects free IgG in serum by first incubating serum with red cells and then adding anti-human globulin to crosslink any IgG that has attached. Used when IgG antibodies are present but do not cause direct agglutination because of electrostatic repulsion.

Related terms

Agglutination titre
The reciprocal of the highest dilution of a serum or antigen solution at which visible agglutination still occurs. A titre of 1:64...
Hemagglutination
Agglutination specifically involving red blood cells as the antigen-bearing particles. Direct hemagglutination occurs when antibodies bind surface antigens naturally present on red...
Low-ionic-strength saline (LISS)
A reaction medium with reduced salt concentration used to enhance agglutination sensitivity, particularly for IgG antibodies. Lowering ionic strength reduces the electrostatic...
Passive (indirect) agglutination
An agglutination format in which a soluble antigen or antibody is adsorbed or covalently linked to a carrier particle (latex bead, tanned...
Prozone (hook) effect
A false-negative agglutination result caused by antibody excess. When antibody molecules outnumber antigen sites, each site is occupied by a single antibody...

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