Donath-Landsteiner test

• Alternative Names

  Anti-P antibody

• How the test is performed

  Blood is drawn from a vein, usually from the inside of the elbow or the back of the hand. The puncture site is cleaned with antiseptic. An elastic band or blood pressure cuff is placed around the upper arm to apply pressure and restrict blood flow through the vein. This causes the vein to swell with blood.

  A needle is inserted into the vein, and the blood is collected in an air-tight vial or a syringe. During the procedure, the band is removed to restore normal blood flow. Once the blood has been collected, the needle is removed, and the puncture site is covered to stop any bleeding.

  In infants or young children, the area is cleansed with antiseptic and punctured with a sharp needle or a lancet. The blood may be collected in a small glass tube (pipette), on a slide, onto a test strip, or into a small container. Cotton or a bandage may be applied to the puncture site if there is any continued bleeding.

• How to prepare for the test

  No special preparation is needed.

• How the test will feel

  When the needle is inserted to draw blood, some people feel moderate pain, while others feel only a prick or stinging sensation. Afterward, there may be some throbbing.

• Why the test is performed

  This test is done to confirm a diagnosis of paroxysmal cold hemoglobinuria.

• Normal Values

  No presence of antibodies is normal.

• What abnormal results mean

  Abnormal results mean Donath-Landsteiner antibodies are present. This is a sign of paroxysmal cold hemoglobinuria (PCH).

  See: Paroxysmal cold hemoglobinuria

• What the risks are

  There is very little risk involved with having your blood taken. Veins and arteries vary in size from one patient 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:

  • Excessive bleeding
  • Fainting or feeling light-headed
  • Hematoma (blood accumulating under the skin)
  • Infection (a slight risk any time the skin is broken)
• References

  Schwartz RS. Autoimmune and intravascular hemolytic anemias. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 164.

Review Date: 2/21/2009

Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.