CAMLPR Evaluation And Interpretation Competency Practice Test

In the G6PD deficiency case, which statement about the direct antiglobulin test (DAT) is true?

The DAT is positive at RT The DAT is negative The DAT is positive at 37C The DAT result is not reported

Correct Answer:

The DAT is negative

Explanation:

The direct antiglobulin test detects antibodies or complement on the surface of red blood cells, helping differentiate immune from non-immune hemolysis. In G6PD deficiency, the hemolysis arises from oxidative injury to red cells, not from immune coating, so red cells are not marked by antibodies or complement. That’s why the test is typically negative in this scenario. If the cause were immune-mediated, you’d expect a positive DAT, and the temperature at which it reacts (positive at 37°C for IgG, or at room temperature for certain cold antibodies) would reflect the type of immune hemolysis. A negative result here supports a non-immune mechanism of hemolysis, which fits G6PD deficiency.

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