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Autoantibodies with mimicking specificity detected by the dilution technique in patients with warm autoantibodies.

Jang MJ, Cho D, Park KU, Yazer MH, Shin MG, Shin JH, Suh SP, Ryang DW - Ann Lab Med (2013)

Bottom Line: Among them, 25 samples were adsorbed with allogeneic ZZAP (a combination of dithiothreitol and enzyme) or polyethylene glycol (PEG) and their RBC phenotypes were determined.The agreement of the results obtained with the dilution technique in combination with RBC phenotyping and those from ZZAP or PEG adsorption was 100% (18/18) in patients who have autoantibodies with mimicking specificity and/or alloantibodies.No clinical symptoms indicating severe acute or delayed hemolytic transfusion reactions were reported in the 39 patients transfused with our pre-transfusion testing algorithm.

View Article: PubMed Central - PubMed

Affiliation: Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Korea.

ABSTRACT

Background: The aim of this study was to investigate the frequency of autoantibodies with mimicking specificity by using the dilution technique, to assess the usefulness of the combination of the dilution technique and red blood cell (RBC) phenotyping, and to establish a pre-transfusion testing algorithm in patients with warm autoantibodies.

Methods: Serum samples from 71 patients with warm autoantibodies were tested using the dilution technique. Among them, 25 samples were adsorbed with allogeneic ZZAP (a combination of dithiothreitol and enzyme) or polyethylene glycol (PEG) and their RBC phenotypes were determined. Thirty-nine patients were transfused with our pre-transfusion testing algorithm using a combination of dilution technique and RBC phenotyping.

Results: Autoantibodies with mimicking specificity were detected by the dilution technique in 26.8% (19/71) of the patients and most of them were directed against Rh system antigens. The agreement of the results obtained with the dilution technique in combination with RBC phenotyping and those from ZZAP or PEG adsorption was 100% (18/18) in patients who have autoantibodies with mimicking specificity and/or alloantibodies. No clinical symptoms indicating severe acute or delayed hemolytic transfusion reactions were reported in the 39 patients transfused with our pre-transfusion testing algorithm.

Conclusions: Autoantibodies with mimicking specificity detected by the dilution technique in patients with warm autoantibodies are relatively frequent, can be discriminated from alloantibodies by employing a combination of dilution technique and RBC phenotyping, and might not appear to cause severe acute or delayed hemolytic transfusion reactions.

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Red cell transfusion workflow in 71 patients having warm autoantibodies evaluated with the combination of dilution technique and red cell phenotyping.
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Figure 1: Red cell transfusion workflow in 71 patients having warm autoantibodies evaluated with the combination of dilution technique and red cell phenotyping.

Mentions: In our retrospective investigation, we transfused "least incompatible" RBCs to 17 patients who shows unidentified pattern in antibody identification test, 10 patients with warm autoantibodies without mimicking specificity, and 5 patients with autoantibodies with mimicking specificity; moreover, we transfused antigen-negative blood to 7 patients with possible alloantibodies identified with our algorithm using a combination of dilution technique and RBC phenotyping (Fig. 1). No clinical symptoms indicating severe acute or delayed hemolytic transfusion reactions were reported in the 39 patients who were transfused with the pre-transfusion testing algorithm.


Autoantibodies with mimicking specificity detected by the dilution technique in patients with warm autoantibodies.

Jang MJ, Cho D, Park KU, Yazer MH, Shin MG, Shin JH, Suh SP, Ryang DW - Ann Lab Med (2013)

Red cell transfusion workflow in 71 patients having warm autoantibodies evaluated with the combination of dilution technique and red cell phenotyping.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3756238&req=5

Figure 1: Red cell transfusion workflow in 71 patients having warm autoantibodies evaluated with the combination of dilution technique and red cell phenotyping.
Mentions: In our retrospective investigation, we transfused "least incompatible" RBCs to 17 patients who shows unidentified pattern in antibody identification test, 10 patients with warm autoantibodies without mimicking specificity, and 5 patients with autoantibodies with mimicking specificity; moreover, we transfused antigen-negative blood to 7 patients with possible alloantibodies identified with our algorithm using a combination of dilution technique and RBC phenotyping (Fig. 1). No clinical symptoms indicating severe acute or delayed hemolytic transfusion reactions were reported in the 39 patients who were transfused with the pre-transfusion testing algorithm.

Bottom Line: Among them, 25 samples were adsorbed with allogeneic ZZAP (a combination of dithiothreitol and enzyme) or polyethylene glycol (PEG) and their RBC phenotypes were determined.The agreement of the results obtained with the dilution technique in combination with RBC phenotyping and those from ZZAP or PEG adsorption was 100% (18/18) in patients who have autoantibodies with mimicking specificity and/or alloantibodies.No clinical symptoms indicating severe acute or delayed hemolytic transfusion reactions were reported in the 39 patients transfused with our pre-transfusion testing algorithm.

View Article: PubMed Central - PubMed

Affiliation: Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Korea.

ABSTRACT

Background: The aim of this study was to investigate the frequency of autoantibodies with mimicking specificity by using the dilution technique, to assess the usefulness of the combination of the dilution technique and red blood cell (RBC) phenotyping, and to establish a pre-transfusion testing algorithm in patients with warm autoantibodies.

Methods: Serum samples from 71 patients with warm autoantibodies were tested using the dilution technique. Among them, 25 samples were adsorbed with allogeneic ZZAP (a combination of dithiothreitol and enzyme) or polyethylene glycol (PEG) and their RBC phenotypes were determined. Thirty-nine patients were transfused with our pre-transfusion testing algorithm using a combination of dilution technique and RBC phenotyping.

Results: Autoantibodies with mimicking specificity were detected by the dilution technique in 26.8% (19/71) of the patients and most of them were directed against Rh system antigens. The agreement of the results obtained with the dilution technique in combination with RBC phenotyping and those from ZZAP or PEG adsorption was 100% (18/18) in patients who have autoantibodies with mimicking specificity and/or alloantibodies. No clinical symptoms indicating severe acute or delayed hemolytic transfusion reactions were reported in the 39 patients transfused with our pre-transfusion testing algorithm.

Conclusions: Autoantibodies with mimicking specificity detected by the dilution technique in patients with warm autoantibodies are relatively frequent, can be discriminated from alloantibodies by employing a combination of dilution technique and RBC phenotyping, and might not appear to cause severe acute or delayed hemolytic transfusion reactions.

Show MeSH
Related in: MedlinePlus