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Citation Information : Immunohematology. Volume 3, Issue 2, Pages 20-22, DOI: https://doi.org/10.21307/immunohematology-2019-1124
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Published Online: 31-December-2020
A 65-year-old woman was found to have severe autoimmune hemolytic anemia. The patient was group A1, RhoD positive. The direct antiglobulin test was strongly positive with anti-C3 and negative with anti-IgG. The serum contained two distinct IgM antibodies, auto-anti-I and auto-anti-AI. Both were reactive at 22°C. However, the anti-AI also was reactive in saline and in albumin at 37°C. An eluate revealed anti-AI and a weak anti-I. Sequential 51Chromium survival studies were done with group OI and AI red cells. The group OI red cells survived normally (97% at 24 hours) while the group A1I red cells were removed in a "two-component" pattern characteristic of IgM complement-fixing antibodies (62% survival at one hour, 49% at 24 hours). Based on these observations, the patient was subsequently transfused without incidence with six group O units of washed red cells prior to splenectomy. Although auto-anti-AI has been previously reported, this is the first case to demonstrate the use of 51Cr survival studies to determine its clinical significance.