Search Through a List of Our Services.
 Immunohematology
  Information for
  Authors
  Links
Find Out How You Can Help.
  Find Your Local
  Red Cross
 Enter Zip Code Here:
 
  Or Browse Through
  A List of Chapters!
Chapters
  Search Our Site
 
Find Out Who Are Supporters Are.
  Find Out Who Our
  Supporters Are

CONTENTS
Immunohematology
Volume 13, Number 1, 1997

ABSTRACTS

A maternal warm-reactive autoantibody presenting as a positive direct antiglobulin test in a neonate
T.D. Williamson, L.H. Liles, and D.P. Blackall

Immune hemolytic anemia due to diclofenac
S.T. Laidlaw, R. Stamps, D.J. Booker, M.J. Brown, and R.J. Sokol

Quantitating fetomaternal hemorrhages of D+ red cells using an FITC-conjugated IgG monoclonal anti-D by flow cytometry: a case report
A. Lubenko, R. Collier, M. Williams, D. Hindmarch, S. Wilson, and J. Pluck

Frequency of neutrophil-specific antigens among Koreans using the granulocyte indirect immunofluorescence test (GIFT)
K.S. Han and T.H. Um

Report on anti-Dib encountered in two Hong Kong Chinese
C.K. Lin, K.H. Mak, N.K. Chan, C.M.Y. Yuen, A. Devenish, H.B. Chan, K.L. Au, and S.C. Szeto

Antibodies to low-incidence antigens and elimination of the antihuman globulin phase of the crossmatch--case report: anti-Wra
S.C. Wise, P.J. Larson, and L.O. Cook

Back to Top


A maternal warm-reactive autoantibody presenting as a positive direct antiglobulin test in a neonate

T.D. Williamson, L.H. Liles, and D.P. Blackall

Autoimmune hemolytic anemia in pregnancy is a rare cause of hemolytic disease of the newborn. This report describes a neonate with a mild hemolytic process and a positive direct antiglobulin test (DAT) presenting as the first manifestations of a maternal warm-reactive autoantibody. A full-term male neonate, blood group O, had a strongly positive DAT and laboratory evidence suggestive of a mild hemolytic process. The neonate's mother was also group O and had a negative antibody screen. Umbilical cord blood testing revealed a panreactive eluate though the antibody was not detected in cord serum. The neonate's mother was also found to have a positive DAT. A panagglutinin was identified in an eluate of her red cells, although the autoantibody could not be detected in her serum by a variety of sensitive techniques. There was no clinical or laboratory evidence of maternal hemolysis.Immunohematology1997;13:68.

Back to Top


Immune hemolytic anemia due to diclofenac

S.T. Laidlaw, R. Stamps, D.J. Booker, M.J. Brown, and R.J. Sokol

A 37-year-old male presented with severe anemia, mild jaundice, and hemoglobinuria during his second course of diclofenac for gout. The peripheral blood showed microspherocytes and nucleated red blood cells (RBCs). The reticulocyte count was 21 percent and haptoglobin was < 0.1 g/L. A presumptive diagnosis of diclofenac-induced immune hemolysis was made and blood, urine, and drug samples were referred for investigation. Direct antiglobulin testing showed the RBCs to be coated with IgG1, IgG4, and C3d, but an eluate only yielded weakly reacting IgG antibodies. In tests for drug-dependent antibodies, group O, R1R2 red cells were incubated with the patient's serum that had been mixed with either urine (which contained diclofenac metabolites) or diclofenac solution and then tested by an antiglobulin method. Strongly positive reactions with anti-IgG occurred in the tests using urine but only weak reactions in those tests employing diclofenac solution. All controls gave negative results. These findings support the role of diclofenac in causing hemolysis and the importance of employing urine as a source of drug metabolites. The findings also showed that an immune complex mechanism predominated and that the eluted IgG (detectable independently of the presence of the drug or its metabolites) confirmed a minor autoimmune component. Diclofenac was stopped and treatment with prednisolone and folic acid instituted; this resulted in complete recovery. Immunohematology 1997;13:911.

Back to Top


Quantitating fetomaternal hemorrhages of D+ red cells
using an FITC-conjugated IgG monoclonal anti-D by flow cytometry: a case report

A. Lubenko, R. Collier, M. Williams, D. Hindmarch, S. Wilson, and J. Pluck

Several methods for quantitating fetomaternal hemorrhages (FMHs) have been described; these include the Kleihauer-Betke and red cell rosetting tests, and flow cytometry that uses an indirect antiglobulin technique, employing either FITC-conjugated IgG/unlabeled anti-D or streptavidin conjugates with biotinylated anti-D to enumerate D+ red cells in maternal blood. We have used a recently described directly conjugated FITC anti-D for direct flow cytometric (direct FC) quantitation of FMH in a patient who presented with a large fetal bleed (approx. 80mL) as determined using the Kleihauer method. We compared the efficacy of the direct FC technique to the rosetting and Kleihauer tests in estimating the quantity of Rh immunoglobulin (RhIg) to be administered to the mother to suppress Rh alloimmunization. Both the Kleihauer and the direct FC gave precise estimates of 80mL for the size of bleed, whereas the rosetting test failed to be as precise. The former tests predicted that a 10,000 iu dose (2,000 g) of RhIg would be adequate; the lack of alloanti-D in a maternal follow-up sample obtained 9 months after delivery supported this prediction and underlined the reliability of the direct FC method as an alternative to the Kleihauer method for quantitating large FMHs. Immunohematology 1997;13:1214.

Back to Top


Frequency of neutrophil-specific antigens among Koreans using the granulocyte indirect immunofluorescence test (GIFT)

K.S. Han and T.H. Um

NA1, NA2, NB1, NB2, NC1, and NE1 are a group of antigens specifically expressed on neutrophils. Antibodies against neutrophil-specific antigens are involved in alloimmune neonatal neutropenia (ANN), autoimmune neutropenia (AIN), and transfusion-related acute lung injury (TRALI). We investigated the frequencies of NA1, NA2, NB1, and Mart antigens in 105 healthy Korean blood donors (65 males, 40 females) by the granulocyte indirect immunofluorescence test (GIFT) employing flow cytometry. Antigen and gene frequencies were: NA1, 0.78 and 0.53, respectively; NA2, 0.75 and 0.50, respectively; and NB1, 0.86 and 0.62, respectively. The Mart antigen was positive in all 105 subjects included in this study. The proportions of NB1-positive neutrophils among NB1-positive individuals were variable with a mean value of 72.0 20.2% (range, 27100%). Differences in the frequency of the NA1 antigen have been reported between Asian and Caucasian populations. Our data support this variation. In addition, it was found that the frequency of the NA1 antigen in Koreans is significantly lower than in Japanese and Chinese populations (p < 0.05). Immunohematology 1997;13:1516.

Back to Top


Report on anti-Dib encountered in two Hong Kong Chinese

C.K. Lin, K.H. Mak, N.K. Chan, C.M.Y. Yuen, A. Devenish, H.B. Chan, K.L. Au, and S.C. Szeto

Two cases of anti-Dib, a rarely encountered antibody, were identified in serum samples referred by hospital blood banks during the past 13 months. Case 1 is a 4l-year-old female who required blood for elective surgery. Case 2 is a premature infant suffering from mild neonatal jaundice on day 2 after birth. The anti-Dib in both cases exhibited marked dosage effect. The titer/score against Di(a+b+) and Di(a-b+) red blood cells (RBCs) in case 1 was 8/10 and 32/32, respectively, and in case 2, 4/18 and 32/46. The monocyte monolayer assay (MMA) also gave a similar pattern of results, being l5 percent and 100 percent reactive when tested with Di(a+b+) and Di(a-b+) RBCs in case 1, and 0.4 percent (within normal range) and l4.4 percent in case 2. The patient in case 1 underwent her operation without blood transfusion. The infant in case 2 was treated by phototherapy and subsequently recovered without the need for exchange transfusion. Immunohematology 1997;13:1719.

Back to Top


Antibodies to low-incidence antigens and elimination of the antihuman globulin phase of the crossmatch--case report: anti-Wra

S.C. Wise, P.J. Larson, and L.O. Cook

An antibody to a low-incidence antigen was identified in the serum of a nontransfused male patient. The antibody was subsequently identified as anti-Wra and was only detectable at the antihuman globulin (AHG) phase of the crossmatch. Instances of severe hemolytic transfusion reactions have been reported following the transfusion of red blood cells containing low-incidence antigens in patients with antibodies directed toward these antigens (e.g., anti-Wra, -Cob, -Jsa, etc.). Elimination of the AHG phase of the crossmatch can result in either risks or benefits. Since patients seen at this facility primarily have been multitransfused or are multiparous females, the AHG phase of the crossmatch has been maintained. Immunohematology 1997;13:2022.

Back to Top


© Copyright The American National Red Cross. All Rights Reserved.
CONTACT US   | SITE DIRECTORY   | PRIVACY POLICY