An, those are when your platelets and red cells get all dressed up with antibodies—means your own immune system is mistakenly attacking them. Direct Coombs test catches that coat, shows it's immune-mediated. But here, without that fancy test, I look at the patient: if they're pale, tired, with strange bruises after a viral fever, I treat for immune destruction. See, last monsoon, my cousin had similar symptoms after dengue; we had to rely on clinical signs and start steroids while arranging a trip to the city lab. Machines don't grow on caju trees, no?
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