 Controversies
| Garratty (1984) |
In vitro detection of red cell-bound complement can be important in the differential diagnosis of autoimmune and drug-induced immune hemolytic anemias; it can also be a sensitive test for the detection of complement-binding alloantibodies, e.g., in compatibility testing. Red cell-bound complement can be detected by the antiglobulin test if suitable antiglobulin sera (AGS) are utilized.
In 1971, the Federal Standards for
AGS were criticized because so-called broad spectrum AGS used routinely in
blood banks were shown to often be deficient in anticomplement reactivity.
In the new few years commercial regents changed with regard to the
quantity and specificity of their anticomplement components. A great deal
of controversy developed as to the true importance of detecting red
cell-bound complement, the particular fragments of complement that should
be detected, and the causes of nonspecific reactions that seemed to be
occurring, especially with the increasing usage of new techniques
utilizing low ionic strength media. When monospecific anti-IgG and anti-C3
became available commercially, the controversy regarding diagnostic
testing was resolved as direct antiglobulin testing could be performed
with these reagents rather than the broad spectrum reagents.
Controversies
Garratty (1984)