Answer: If you’ve been feeling fatigued, have shortness of breath, cold hands and feet, and very pale skin, you may have an insufficient amount of red blood cells. This condition is called anemia, and it has many causes. If your doctor confirms that you have a low red blood cell count, the Coombs test is one of the blood tests your doctor may order to help find out what kind of anemia you have. The Coombs test will help your doctor determine if you have antibodies in your bloodstream that are causing your immune system to attack and destroy your own red blood cells. If your red blood cells are being destroyed, this can result in a condition called hemolytic anemia. There are two types of Coombs tests: the direct Coombs test and the indirect Coombs test. The direct test is more common and checks for antibodies that are attached to the surface of your red blood cells. The indirect test checks for unattached antibodies that are floating in the bloodstream. It’s also administered to determine if there was a potential bad reaction to a blood transfusion. Results are considered normal if there’s no clumping of red blood cells. A clumping of the red blood cells during the test indicates an abnormal result. Agglutination (clumping) of your blood cells during a direct Coombs test means that you have antibodies on the red blood cells and that you may have a condition that causes the destruction of red blood cells by your immune system, called hemolysis. An abnormal result in an indirect Coombs test means you have antibodies circulating in your bloodstream that could cause your immune system to react to any red blood cells that are considered foreign to the body — particularly those that may be present during a blood transfusion.
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