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Anaphylactic reactions are excluded by the presence of red plasma or urine, discordant pretransfusion and posttransfusion ABO blood types, or a positive direct antiglobulin (Coombs) test result. Demonstration of anti-IgA in a pretransfusion sample of the recipient's serum or plasma establishes the diagnosis.
In-Vitro Adulteration. When the urine is safely out of the body, people are more apt to add a chemical agent to the specimen. This is most commonly done when the actual collection is not being observed or when the collector fails to thoroughly check the body and belongings of the donor.