About 5-10% of patients with autoimmune hemolytic anemia (AIHA) and a negative result on the direct antiglobulin test (DAT) are difficult to diagnose. Most of these patients with have red blood cell-associated IgG levels below the cut-off value of DAT. Comprehensive diagnosis and classification of DAT-negative can be made with additional tests of low-affinity IgG and IgA/IgM autoantibodies. However, 17% of patients with DAT-negative show negative results on all these tests and are diagnosed with clinically diagnosed DAT-negative AIHA, after excluding other hemolytic anemias and responsiveness to steroids. This percentage can be reduced to 4% if tests are conducted during pretreatment stage. Patients with clinically diagnosed DAT-negative AIHA show relatively worse prognosis than patients with low-affinity IgG, and tend to receive treatment in the later stages of the disease. When treating a patient with DAT-negative hemolysis, DAT-negative should be considered and tested in reference laboratories, especially at pretreatment stage.

Toyomi Kamesaki

Rinshō ketsueki/Rinshou ketsueki

Marine Ecology publishes original contributions on the structure and dynamics of marine benthic and pelagic ecosystems, communities and populations, and on the critical links between ecology and the evolution of marine organisms.

The journal prioritizes contributions elucidating fundamental aspects of species interaction and adaptation to the environment through integration of information from various organizational levels (molecules to ecosystems) and different disciplines (molecular biology, genetics, biochemistry, physiology, marine biology, natural history, geography, oceanography, palaeontology and modelling) as viewed from an ecological perspective. The journal also focuses on population genetic processes, evolution of life histories, morphological traits and behaviour, historical ecology and biogeography, macro-ecology and seascape ecology, palaeo-ecological reconstruction, and ecological changes due to introduction of new biota, human pressure or environmental change.

Most applied marine science, including fisheries biology, aquaculture, natural-products chemistry, toxicology, and local pollution studies lie outside the scope of the journal.  Papers should address ecological questions that would be of interest to a worldwide readership of ecologists; papers of mostly local interest, including descriptions of flora and fauna, taxonomic descriptions, and range extensions will not be considered.

The journal '[Rinsho ketsueki] The Japanese journal of clinical hematology' publishes original research contributions on marine ecology, focusing on the structure and dynamics of marine benthic and pelagic ecosystems, communities, and populations, as well as the critical links between ecology and the evolution of marine organisms. The journal prioritizes contributions that elucidate fundamental aspects of species interactions and environmental adaptations, integrating information from various organizational levels (from molecules to ecosystems) and different disciplines (molecular biology, genetics, biochemistry, physiology, marine biology, natural history, geography, oceanography, paleontology, and modeling) from an ecological perspective. It also focuses on population genetic processes, the evolution of life histories, morphological traits and behavior, historical ecology and biogeography, macroecology and seascape ecology, paleoecological reconstruction, and ecological changes due to the introduction of new biota, human pressure, or environmental change. Most applied marine sciences, including fisheries biology, aquaculture, natural products chemistry, toxicology, and local pollution studies, fall outside the scope of the journal. Papers should address ecological questions of interest to a global readership of ecologists; papers primarily focused on local issues, including descriptions of flora and fauna, taxonomic descriptions, and range extensions, will not be considered.

《[Rinsho ketsueki] The Japanese journal of clinical hematology》致力于发表关于海洋生态学的原创研究，涵盖海洋底栖和浮游生态系统、群落和种群的结构与动态，以及生态学与海洋生物进化之间的关键联系。期刊优先考虑阐明物种相互作用和环境适应的基本方面的贡献，这些研究通过整合来自不同组织层次（从分子到生态系统）和不同学科（分子生物学、遗传学、生物化学、生理学、海洋生物学、自然历史、地理学、海洋学、古生物学和建模）的信息，从生态学的角度进行分析。期刊还关注种群遗传过程、生活史进化、形态特征和行为、历史生态学和生物地理学、宏观生态学和海景生态学、古生态重建，以及由于新生物引入、人类压力或环境变化导致的生态变化。大多数应用海洋科学，包括渔业生物学、水产养殖、天然产物化学、毒理学和地方污染研究，均不在期刊的范围之内。论文应针对全球生态学家感兴趣的生态问题；主要关注地方性问题的论文，包括植物和动物的描述、分类描述和分布扩展，将不予考虑。

[Diagnosis and classification of direct antiglobulin test-negative autoimmune hemolytic anemia].

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