{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T11:35:19Z","timestamp":1788348919943,"version":"build-2803163510"},"reference-count":16,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2002,7,1]]},"abstract":"<jats:p>Objective. It is stated that the direct antiglobulin (Coombs\u2019) test (DAT) may be negative in ABO hemolytic disease of the newborn. Thus, significant jaundice in neonates who are A-B incompatible with their mothers but DAT test negative is often attributed to isoimmunization and another diagnosis is not sought. We wished to determine the rate of bilirubin production, as an objective measure of hemolysis, in 2 groups of DAT-negative neonates\u2014ABO-compatible and ABO-incompatible\u2014and in DAT-positive ABO-incompatible neonates.<\/jats:p><jats:p>Methods. In consecutive, term, healthy newborns who were admitted to the general care nursery, we measured the level in parts per million (ppm) of end-tidal breath carbon monoxide (CO), corrected for inspired CO (ETCOc), an index of the rate of bilirubin production. We compared the levels in DAT-negative ABO-incompatible neonates with those in ABO-compatible neonates and with the levels in DAT-positive ABO-incompatible neonates. Statistical analysis was performed using 2-sample t and \u03c72 tests.<\/jats:p><jats:p>Results. There was no significant difference between the mean 12-hour ETCOc levels in DAT-negative ABO-incompatible neonates (n = 60, 2.2 \u00b1 0.6 ppm) versus DAT-negative ABO-compatible neonates (n = 171, 2.1 \u00b1 0.6 ppm), although there was a difference between the mean levels in DAT-positive ABO-incompatible neonates (n = 14, 3.4 \u00b1 1.8 ppm) and the DAT-negative groups. Four DAT-negative ABO-incompatible neonates had elevated ETCOc levels; in 2, we diagnosed a specific hematologic abnormality, namely, glucose-6-phosphate dehydrogenase deficiency in 1 and elliptocytosis in the other.<\/jats:p><jats:p>Conclusion. In DAT-negative newborns with significant jaundice or increased bilirubin production, even if ABO-incompatible, a cause other than isoimmunization should be sought.<\/jats:p>","DOI":"10.1542\/peds.110.1.127","type":"journal-article","created":{"date-parts":[[2004,8,14]],"date-time":"2004-08-14T00:17:55Z","timestamp":1092442675000},"page":"127-130","source":"Crossref","is-referenced-by-count":48,"title":["Isoimmunization Is Unlikely to Be the Cause of Hemolysis in ABO-Incompatible but Direct Antiglobulin Test-Negative Neonates"],"prefix":"10.1542","volume":"110","author":[{"given":"Marguerite","family":"Herschel","sequence":"first","affiliation":[{"name":"Departments of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodore","family":"Karrison","sequence":"additional","affiliation":[{"name":"Health Studies"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Wen","sequence":"additional","affiliation":[{"name":"Health Studies"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie","family":"Caldarelli","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beverly","family":"Baron","sequence":"additional","affiliation":[{"name":"Pathology, the University of Chicago Pritzker School of Medicine, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2002,7,1]]},"reference":[{"key":"2021121006174288400_R1","unstructured":"Queenan JT. 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