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Short Communication | 15-March-2016

IgG Avidity: an Important Serologic Marker for the Diagnosis of Tick-Borne Encephalitis Virus Infection

A total of 52 serum samples from patients with symptoms suggestive of tick-borne encephalitis virus (TBEV) infection and positive IgM and/or IgG antibodies were tested for IgG avidity. Acute/recent TBEV infection was confirmed by low/borderline avidity index (AI) in 94.8% IgM positive/IgG positive samples, while in 5.2% high AI was found indicating persisting IgM antibodies. Majority of IgM negative/IgG positive samples (78.6%) showed high AI consistent with past TBEV infection. However, in

Tatjana Vilibic-Cavlek, Ljubo Barbic, Vladimir Stevanovic, Goranka Petrovic, Gordana Mlinaric-Galinovic

Polish Journal of Microbiology, Volume 65 , ISSUE 1, 119–121

original-paper | 27-March-2019

Clinical Interpretation of Detection of IgM Anti-Brucella Antibody in the Absence of IgG and Vice Versa; a Diagnostic Challenge for Clinicians

examination has led to consider other diagnostic techniques more useful in the diagnostic workup of brucellosis. Serologically, ELISA is the most popular and widely used diagnostic assay. Brucella-specific IgM antibodies are produced in the first week after the disease onset, reaching a maximum after two months. On the other hand, IgG antibodies are detected after the second week of infection, attaining a peak level of six to eight weeks later. While IgG response coincides more closely with the clinical


Polish Journal of Microbiology, Volume 68 , ISSUE 1, 51–57

Article | 09-November-2020

Direct Coombs test-negative autoimmune hemolytic anemia and low-affinity IgG class antibodies

Autoimmune hemolytic anemia, in which the direct antiglobulin test (DAT) is negative or weakly positive, may be due to low-affinity autoantibodies. We describe two such cases. An 8-year-old male presented with weight loss, jaundice, a hemoglobin of 33 g/L, reticulocytes of 306 x 109/L, and haptoglobin of < 0.1 g/L. The DAT was negative. After washing the red blood cells (RBCs) with saline at 4°C, the DAT was positive for IgG and an eluate contained an IgG3 autoantibody, thus confirming a

R.J. Sokol, D.J. Booker, R. Stamps, S. Jalihal, B. Paul

Immunohematology, Volume 13 , ISSUE 4, 115–118

Article | 14-October-2020

Quantitation of red cell–bound IgG, IgA, and IgM in patients with autoimmune hemolytic anemia and blood donors by enzymelinked immunosorbent assay

This paper describes an enzyme immunoassay for the quantitative determination of IgG, IgA, and IgM immunoglobulins on RBCs. Ether eluates made from RBCs were followed by an enzyme-linked immunosorbent assay of immunoglobulin concentration. Calibration curves were derived from immunoglobulin standards and the number of molecules of each isotype per RBC was calculated. The assay was carried out in 200 healthy blood donors and 62 patients with warm autoimmune hemolytic anemia (AIHA), two of them

Antonio A. Bencomo, Martha Díaz, Yalile Alfonso, Odalys Valdés, María E. Alfonso

Immunohematology, Volume 19 , ISSUE 2, 47–53

Article | 14-October-2020

Murine monoclonal antibodies can be used to type RBCs with a positive DAT

RBCs with a positive DAT due to IgG coating require the use of directly agglutinating reagents or treatment with chemicals to remove sufficient IgG to permit typing of the RBCs with antisera that require use of the IAT. In this study we demonstrate that murine IgG MoAbs to human RBC antigens can be used as an alternative if the anti-mouse IgG is neutralized or affinity purified to prevent cross-reaction with cell-bound IgG. We performed DATs on RBC samples coated with IgG in vivo and in vitro

Gregory R. Halverson, Paula Howard, Harry Malyska, Edith Tossas, Marion E. Reid

Immunohematology, Volume 19 , ISSUE 3, 83–85

Report | 29-October-2019

Demonstration of IgG subclass (IgG1 and IgG3) in patients with positive direct antiglobulin tests

Serologic characterization of autoantibodies helps in the management and monitoring of the course of autoimmune hemolytic anemia (AIHA). The purpose of this study was to evaluate gel centrifugation test (GCT) cards for immunoglobulin G (IgG) titer and determination of IgG subclasses IgG1 and IgG3 and their influence on hemolysis. Eighty direct antiglobulin test (DAT)-positive patients were examined with the help of GCT cards for IgG titer and IgG subclasses. The results were correlated with the

Ashutosh Singh, Archana Solanki, Rajendra Chaudhary

Immunohematology, Volume 30 , ISSUE 1, 24–27

Article | 18-October-2020

A quick and simple method for phenotyping IgG-sensitized red blood cells

Positive (IgG) direct antiglobulin test (DAT) reactivity ranging from weakly positive to 2+ can be eliminated using a simple “blocking” technique with anti-IgG. This method can be used for antigen typing DAT-positive red blood cells that require the antiglobulin technique.

Thom S. Sererat, Douglas W. Veidt, Ann M. Dutched

Immunohematology, Volume 16 , ISSUE 4, 154–156

Case report | 20-December-2020

A case report: IgG autoanti-N as a cause of severe autoimmune hemolytic anemia

anti-N activity, and radioimmunoassay with monoclonal anti-IgG was strongly positive, indicating that both the cold- and the warm-reacting anti-N reactivity resided in the IgG fraction. The patient was treated with N - ‘N’ + red cell transfusions, prednisone, and azathioprine and gradually became transfusion independent. Postrecovery typing revealed her red cells to be M+N+S+s+. This constitutes the third case of autoimmune hemolytic anemia associated with IgG autoanti-N. The marked

Martha Rae Combs, Marilyn J. Telen, Sharon E. Hall, Wendell F. Rosse

Immunohematology, Volume 6 , ISSUE 4, 83–86

Review | 01-December-2019

EDTA glycine acid treatment of red blood cells

IgG dissociation is necessary when a sample is direct antiglobulin test (DAT) positive and antigen testing using blood grouping serum reactive by the antiglobulin test is performed. Exposure of IgG-coated red blood cells (RBCs) to a low pH of 3.0 with EDTA glycine acid successfully dissociates the IgG, rendering the RBCs DAT negative 82 to 85 percent of the time. The procedure takes one minute or less and leaves RBC antigens intact and able to be typed except for those antigens in the Kell

Joanne Kosanke

Immunohematology, Volume 28 , ISSUE 3, 95–96

Article | 10-April-2021

Group O blood donors in Iran: evaluation of isoagglutinin titers and immunoglobulin G subclasses

, and all four IgG subclasses can be produced in an individual with high-titer isoagglutinins.15 In this study, we aimed to find the most frequent titer of anti-A and anti-B (IgM and IgG) in Iranian group O blood donors. Because there are no previous studies on the frequency of isoagglutinin titers in Iran, our study will assess information from group O blood donors in this country for the first time to highlight the importance of studying isoagglutinin titers in each unique population. Furthermore

S. Arabi, M. Moghaddam, A.A. Pourfathollah, A. Aghaie, M. Mosaed

Immunohematology, Volume 37 , ISSUE 1, 5–12

Short Communication | 28-June-2017

The Serological Surveillance of Hepatitis E virus among Hunters and Foresters in Eastern Poland

The aim of the study was the analysis of the occurrence of specific antibodies against HEV among hunters and foresters who are at risk to be exposed. The study group consisted of 210 hunters (23–80 years old) and 60 foresters (22–64 years old). Anti-HEV IgG were present in 3.81% of the samples of the hunters and in 5% of the samples of the foresters. The statistical analysis shows no significant differences inthe results anti-HEV IgG between the groups of hunters and foresters (p

Marcin Weiner, Małgorzata Tokarska-Rodak, Dorota Plewik, Anna Pańczuk, Adam Szepeluk, Monika Krajewska

Polish Journal of Microbiology, Volume 66 , ISSUE 2, 277–279

Article | 15-April-2020

Efficacy of murine monoclonal antibodies in RBC phenotyping of DAT-positive samples

Determining the phenotype of patient RBCs that are positive by the DAT may prove problematic. Antigen typing of RBCs coated with IgG requires direct agglutinating reagents or chemical treatment (such as chloroquine diphosphate [CDP] or citric acid) to remove sufficient IgG to permit testing with IAT-reactive reagents. The citric acid elution method is commonly used in the United States; however,antigens in the Kell system are altered to the extent that they may appear to be absent by this

Edmond Lee, Kevin Hart, Gordon Burgess, Gregory R. Halverson, Marion E. Reid

Immunohematology, Volume 22 , ISSUE 4, 161–165

Article | 18-October-2020

Significant ABO hemolytic disease of the newborn in a group B infant with a group A2 mother

ABO hemolytic disease of the newborn (HDN) occurs almost exclusively in infants of blood group A or B who are born to group O mothers because IgG anti-A or -B occurs more commonly in group O than in group A or B individuals. We report a case in which clinically significant ABO-HDN occurred in a group B neonate from anti-B of a group A2 mother. The IgG anti-B titer was much higher (256) than that found in a group A1 mother/infant control group (≤ 32). The maternal antibody screen was negative

Hye-Ran Jeon, Beverly E.W. Calhoun, Mohammad Pothiawala, Marguerite Herschel, Beverly W. Baron

Immunohematology, Volume 16 , ISSUE 3, 105–108

Report | 09-October-2019

A detailed flow cytometric method for detection of low-level in vivo red blood  cell–bound IgG, IgA, and IgM

Flow cytometric methods are commonly used to analyze white blood cell surface antigen expression. We developed a flow cytometric method to detect red blood cell (RBC)-bound immunoglobulin (Ig)G, IgA, and IgM. RBCs were washed; incubated with fluorescein isothiocyanate (FITC)-conjugated anti-IgG, -IgA, or -IgM; washed; and analyzed on the flow cytometer. The method was optimized by determining the dilution of FITC-conjugated anti-IgG, -IgA, and -IgM providing the greatest amount of fluorescence

Wendy Beres, Geralyn M. Meny, Sandra Nance

Immunohematology, Volume 32 , ISSUE 4, 161–169

Report | 14-March-2020

Absence of hemolytic disease of fetus and newborn despite maternal high-titer IgG anti-Ku

elution of RBC antibodies, and antigen typing. A gravida 3, para 3 (G3P3) woman was first evaluated in 2006 and was found to have an IgG RBC antibody that reacted against all panel RBCs in the anti-human globulin phase. A panel of RBCs treated with DTT did not react with the antibody.  The antibody failed to react with one example of K0 RBCs. The patient’s RBCs typed negative for the following Kell blood group antigens: KEL1, KEL2, KEL3, KEL4, KEL6, KEL7, KEL11, KEL13, and KEL18. These

Ram M. Kakaiya, Angelica Whaley, Christine Howard-Menk, Jigna Rami, Mona Papari, Sally Campbell-Lee, Zbigniew Malecki

Immunohematology, Volume 26 , ISSUE 3, 119–122

Article | 14-October-2020

Comparative testing for weak expression of D antigen: manual tube testing vs. a semiautomated IgG gel system

Donor RBCs nonreactive in initial tests for D must be tested further for evidence of weak expression of D antigen. Performing this test in test tubes is labor intensive and prone to inconsistencies in readings (relative strength of agglutination) and interpretation (positive versus negative). These inconsistencies can lead to repeat testing, additional documentation, and delay in releasing units. We evaluated use of the Tecan MEGAFlex-ID™ pipettor to perform this test in anti-IgG gel

Bill A. Martinez, Liz A. Crews, Arlene M. Dowd, Melissa McMahan

Immunohematology, Volume 19 , ISSUE 1, 7–9

Review | 01-December-2019

Cold acid elution (ELU Kit II)

-Kit II is a very popular method for the elution of immunoglobulin G (IgG) antibodies.

Monica Hinrichs, Monica A. Keith

Immunohematology, Volume 30 , ISSUE 3, 113–116

Original Paper | 28-December-2016

High Seroprevalence of CMV Among Women of Childbearing Age Implicates High Burden of Congenital Cytomegalovirus Infection in Poland

Cytomegaloviruses are common worldwide, with variable frequency of infections. The infection in pregnancy may lead to pregnancy loss or serious sequelae for the child. To understand the risk posed by CMV in Poland we conducted cross-sectional study on women aged 15–49 basing on existing serum bank. Age dependent CMV incidence, the rates of congenital infection and sequelae were modelled from sero-prevalence, literature and demographic data. The overall anti-CMV IgG prevalence was 81.9

Joanna Siennicka, Milena Dunal-Szczepaniak, Agnieszka Trzcińska, Paulina Godzik, Magdalena Rosińska

Polish Journal of Microbiology, Volume 65 , ISSUE 4, 425–432

Case report | 09-November-2020

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

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

Anatole Lubenko, John Raymond Collier, Mark Williams, Damien Hindmarch, Sally Rosemary Wilson, Julie Pluck

Immunohematology, Volume 13 , ISSUE 1, 12–14

Article | 10-April-2021

Comparative evaluation of the conventional tube test and column agglutination technology for ABO antibody titration in healthy individuals: a report from India

transplantation.4 The most common and recommended method for ABO antibody titration is the conventional tube test (CTT). Testing by the CTT-immediate spin (IS) using normal-ionic-strength saline is commonly used for determination of IgM antibody, and testing by the CTT-antihuman globulin (AHG) by indirect antiglobulin test (IAT) is recommended for determination of IgG reactivity.3 Titers are generally determined using a semiquantitative assay by serial double-fold dilution; the titer cutoff value is

S.S. Datta, S. Basu, M. Reddy, K. Gupta, S. Sinha

Immunohematology, Volume 37 , ISSUE 1, 25–32

Article | 17-November-2020

Detection of Lewis, P1, and some MNS blood group system antibodies by a solid phase assay

Some solid phase red cell adherence (SPRCA) assays are designed to detect IgG antibodies to red blood cell (RBC) antigens. These assays use anti-IgG-coated red cells as the indicator. It is reported that most antibodies to Lea, Leb, P1, M, and N fail to react by solid phase (SP), presumably because they are IgM antibodies. Those detected are assumed to be IgG. In one year, during routine testing using SPRCA to screen patients for intended RBC transfusion, 28 of 59 such examples were found

Susan Rolih, Ronald Thomas, Lyle Sinor

Immunohematology, Volume 11 , ISSUE 3, 78–80

Report | 14-March-2020

Attempts to support an immune etiology in 800 patients with direct antiglobulin test–negative hemolytic anemia

Clinical and hematologic evidence of warm autoimmune hemolytic anemia (AIHA) is present in some patients whose direct antiglobulin test (DAT) is negative. The most common causes for AIHA associated with a negative DAT are RBC-bound IgG below the sensitivity threshold of the DAT, RBC-bound IgA and IgM not detectable by routine reagents, and low-affinity IgG that dissociates during the testing process. Samples submitted from 800 patients with hemolytic anemia and a negative DAT were tested by an

Regina M. Leger, Asuncion Co, Penny Hunt, George Garratty

Immunohematology, Volume 26 , ISSUE 4, 156–160

Article | 10-November-2020

Detection of tube agglutination 37°C-only antibodies by solid-phase red cell adherence

There are no published data on the detection of tube agglutination (TA) 37°C-only antibodies by solid-phase (SP) red cell adherence assays using anti-IgG-coated indicator red cells. Thirteen examples of TA 37°C-onIy antibodies were tested by conventional SP methods. Four TA 37°C-only antibodies failed to react by SP. Three were anti-Lea, considered clinically insignificant, and one was anti-E, an anti­body of potential clinical significance. The remaining nine TA 37°C-only

Susan Rolih, Fern Fisher, Dolores Fiqueroa, Gwenn Lindsay

Immunohematology, Volume 12 , ISSUE 1, 27–29

Original Paper | 10-December-2018

A Special Risk Group for Hepatitis E Infection: The First Record of North Cyprus

Abstract Hepatitis E virus (HEV) is transmitted by a fecal oral route from animals to humans following exposure to the body fluids of infected animals. We investigated the seroprevalence of anti-hepatitis E (anti-HEV) antibodies by monitoring IgG and IgM virus antibodies amongst employees in the animal industry in North Cyprus through a cross-sectional study. Samples were taken from individuals without occupational exposure to animals and from those who worked with animals (doing animal


Polish Journal of Microbiology, Volume 67 , ISSUE 4, 525–528

Article | 14-October-2020

Drug-dependent antibodies with immune hemolytic anemia in AIDS patients

We studied the presence of drug-dependent antibodies (D-DAbs) in 53 patients with AIDS who developed immune hemolytic anemia (IHA). We examined sera and eluates for the presence of D-DAbs. Drug antibodies were detected in 43.4 percent (23/53) of the patients with IHA. Antibodies to more than one drug were detected in 60.8 percent (14/23) of patients with drug-induced IHA (D-IHA). The DAT was positive by RBC-bound IgG in eight patients, RBCbound IgG/C3d in nine, IgG/IgA in three, IgG/IgA/C3d in

Carlos A. González, Liliana Guzmán, Gabriela Nocetti

Immunohematology, Volume 19 , ISSUE 1, 10–15

Case report | 29-December-2020

Evaluation of a complement-dependent anti-Jka by various sensitization and detection methodologies: a case report

A 79-year-old woman with a diagnosis of lower gastrointestinal bleeding was found to have a complement-dependent anti-Jka in her serum. The anti-Jka was evaluated by the antiglobulin technique with polyspecific, anti-C3, and anti-IgG antihuman globulin (AHG). A variety of sensitization and detection methods were used, including the prewarmed saline technique, enzyme treatment of test cells, a low-ionic additive solution (LISS), 22 percent albumin, Polybrene, and an increased serum/cell ratio

E. Nicole DeLong

Immunohematology, Volume 4 , ISSUE 3, 59–63

Article | 06-December-2020

Evaluation of patients with positive direct antiglobulin tests and nonreactive eluates discovered during pretransfusion testing

Charts from a series of 679 hospital patients with positive direct antiglobulin tests (DATs) were reviewed. Sixty-three adult patients who demonstrated positive DATs due to IgG only but with nonreactive eluates were selected for further retrospective evaluation. Those patients were noted to fall into four distinct categories: autoimmune diseases including SLE, renal diseases, multiple myeloma, and miscellaneous diseases. In 16 patients for whom serum IgG levels were available, a significant

Jerald A. Clark, Patricia C. Tanley, Charles H. Wallas

Immunohematology, Volume 8 , ISSUE 1, 9–12

Article | 16-October-2019

Sulfhydryl treatment of serum or plasma for the reduction of IgM antibodies

Dithiothreitol (DTT) and 2-mercaptoethanol (2-ME) are sulfhydryl compounds that can be used to treat serum or plasma to denature IgM antibody reactivity. By using sulfhydryl agents, IgG and IgM antibodies can be separated, the relative amount of IgM and IgG antibodies can be determined, and the risk of hemolytic disease of the fetus and newborn can be assessed.

Lorraine N. Blagg

Immunohematology, Volume 34 , ISSUE 4, 135–139

Case report | 12-March-2020

Role for serial prenatal anti-Vel quantitative serologic monitoring with 2-ME serum treatment during pregnancy: case report

trimester (week 7) of her second pregnancy. Interval measurements of the serologic antibody titers were performed during the next 26 weeks. The untreated serum (IgM and IgG) titer increased from a baseline of 4 to 16 during that interval, while the 2-ME (presumed IgG component) titer remained stable at 4. Responding to ultrasound findings suspicious for fetal anemia, the child was delivered without complications at 34 weeks’ gestation. At birth, the DAT was negative and there was no evidence of

Walter J. Linz, Judith T. Fueger, Steven Allen, Susan T. Johnson

Immunohematology, Volume 26 , ISSUE 1, 8–10

Case report | 17-March-2020

Clinical evaluation for lymphoproliferative disease prompted by finding of IgM warm autoanti-IT in two cases

Anti-IT is an unusual specificity originally described as a naturally occurring cold agglutinin. The antibody reacts strongly with cord RBCs, weakly with adult I RBCs, and most weakly with the rare adult i RBCs. IgG anti-IT in patients with hemolytic anemia has been associated with Hodgkin’s lymphoma. Difficulties in blood grouping tests and the presence of a warm reactive agglutinin in samples from two patients with hemolytic anemia led to further serologic studies and the identification

Regina M. Leger, Frederick Lowder, Maria C. Dungo, Weip Chen, Holli M. Mason, George Garratty

Immunohematology, Volume 25 , ISSUE 2, 60–62

Case report | 17-November-2020

Case report: a pregnant woman with immune thrombocytopenic purpura and unusual red cell antibodies

Maternal immune thrombocytopenic purpura (ITP) may lead to fetal platelet destruction. This process is mediated by IgG platelet autoantibodies that cross the placenta. In this case, not only were platelet autoantibodies present, but red cell alloantibodies anti-E, anti-M, and anti-He were also present. Anti-E, present as an IgG antibody, crossed the placenta, but did not cause clinical problems in the E+ newborn, other than possible hyperbilirubinemia that was treated by phototherapy.

Carmela R. Nanton, Sharon M. Martin, Lloyd O. Cook, Patricia J. Larison

Immunohematology, Volume 11 , ISSUE 4, 153–155

original-paper | 04-June-2020

Performance Evaluation of Different Commercial Serological Kits for Diagnosis of Acute Hepatitis E Viral Infection

, known as HEV-7 and HEV-8, were also found to infect camels and humans (Al-Sadeq et al. 2017). Currently, HEV’s diagnosis depends on specific serological and nucleic acid tests, as the clinical manifestations and routine laboratory measures of HEV are similar to those of other acute hepatitis (Zhang et al. 2019). There are four major methods for diagnosing hepatitis E, including the detection of anti-HEV IgM and IgG antibodies, the antigen (Ag), and HEV RNA. Presently, the clinical diagnosis of acute


Polish Journal of Microbiology, Volume 69 , ISSUE 2, 217–222

Article | 03-November-2020

Comparison of affinity column technology and LISS tube tests

Proteins G and A coated on agarose have been extensively used in affinity chromatography. Protein G will bind to all four subclasses of human IgG and protein A to the subclasses IgG1, IgG2, and IgG4. This IgG binding ability of protein G and protein A has been used in a red cell affinity column technology developed for the detection and identification of IgG red cell antibodies. When serum or plasma is incubated in a microcolumn with red blood cells (RBCs) that express the appropriate antigens

Kayla D. Champagne, Peggy Spruell, Jane Chen, Leslie Voll, Gloria Schlanser, Marilyn Moulds

Immunohematology, Volume 14 , ISSUE 4, 149–151

Report | 16-March-2020

Development and validation of a fluorescent microsphere immunoassay for anti-IgA

Anti-IgA may cause anaphylactic transfusion reactions in IgAdeficient individuals. Testing for IgG anti-IgA is useful to identify persons at risk. This report describes an immunoassay for antiIgA that uses polyclonal IgA coupled to fluorescent microspheres as an immunosorbent. Anti-IgA is detected by phycoerythrin- labeled anti-IgG. The assay is calibrated in arbitrary units by use of a serum that contains anti-IgA. Dose-response studies with sera that contain anti-IgA showed positive responses

Kandelaria M. Rumilla, Jeffrey L. Winters, Jessica M. Peterman, Eric A. Jedynak, Henry A. Homburger

Immunohematology, Volume 25 , ISSUE 1, 24–28

Article | 01-April-2020

Reduced red blood cell destruction by antibody fragments

Antibodies to blood group antigens can cause immune RBC destruction directly (extravascular destruction) or indirectly through subsequent complement activation (intravascular hemolysis). The Fc portion of the IgG antibody is responsible for the effector functions of immune RBC destruction. We hypothesized that sensitization of RBCs with blood group antigen–specific IgG antibodies lacking their Fc portion would escape from the recipient’s immune system, allowing for a longer survival

Amina Mqadmi, Steven Abramowitz, Xiaoying Zheng, Karina Yazdanbakhsh

Immunohematology, Volume 22 , ISSUE 1, 11–14

Article | 14-October-2020

Serologic aspects of treating immune thrombocytopenic purpura using intravenous Rh immune globulin

In patients with immune thrombocytopenic purpura (ITP), IgG autoantibody-coated platelets are phagocytized by mononuclear macrophages, primarily in the spleen. Intravenous Rh immune globulin (IV RhIG) has been used since 1983 to treat D+, nonsplenectomized patients with ITP. The beneficial therapeutic effect of IV RhIG is attributed to competitive inhibition of phagocytosis of IgG-coated platelets by IgG anti-D-coated D+ red blood cells (reticuloendothelial or Fc receptor blockade). Following

Can M. Savasman, S. Gerald Sandler

Immunohematology, Volume 17 , ISSUE 4, 106–110

Article | 06-December-2020

Clinical correlation of positive direct antiglobulin tests in patients with sickle cell disease

with sickle cell disease and serologic findings of autoimmune hemolytic anemia, but only one had increased RBC destruction attributed to the autoantibody. That patient’s RBCs had IgG and complement on the surface, while those of the other patient had IgG without complement. Functional asplenism may diminish the role of an IgG autoantibody that does not bind complement, since RBCs coated with complement are removed by the liver. Therefore, complement-binding autoantibodies may have particular

Raymond L. Comenzo, Marie E. Malachowski, Eugene M. Berkman

Immunohematology, Volume 8 , ISSUE 1, 13–16

Letter to Editor | 15-April-2020

A reminder that ZZAP reagent removes complement in addition to IgG from coated RBCs

Regina M. Leger, George Garratty

Immunohematology, Volume 22 , ISSUE 4, 205–206

Case report | 20-March-2020

New serologic findings in a patient with ulcerative colitis and a warm autoantibody

IgG-RBC sensitization associated with serine proteases is the current prevailing hypothesis used to explain an uncommon phenomenon in which a positive DAT is obtained using the RBCs from a patient’s clotted blood sample but a negative DAT is obtained when testing RBCs from the patient’s unclotted sample. Similarly, the patient’s serum but not plasma will also be reactive by IAT against all RBCs tested. The majority of patients demonstrating this phenomenon have had a history

Thomas G. Lightfoot, Laurie Delia VanThof

Immunohematology, Volume 25 , ISSUE 4, 160–164

Article | 16-October-2019

Assessment of common red blood cell pretreatments to yield an accurate serologic antigen phenotype compared with genotype-predicted phenotype

or by a positive direct antiglobulin test (DAT). Because a donor RBC can survive in circulation for up to 120 days, it is not recommended to phenotype individuals who have been transfused in the past 3 months.6 In addition, phenotyping with certain types of antisera may be hindered in patients with autoantibodies causing a positive DAT. In these scenarios, methods—such as EDTA glycine acid (EGA) treatment to remove IgG, hypotonic wash to separate autologous cells from patients with sickle cell

T. Horn, J. Hamilton, J. Kosanke, V.W. Hare, W. Kluver, W. Beres, S. Nance, M.A. Keller

Immunohematology, Volume 33 , ISSUE 4, 147–151

Short Communication | 09-March-2018

Comparative Seroprevalence of Hepatitis A And E Viruses in Blood Donors from Wielkopolska Region, West-Central Poland

The objective of the present study was to investigate the seroprevalence of HAV and HEV in Polish blood donors (BDs). One hundred and ten randomly selected healthy BDs, living in Wielkopolska Region were tested for anti-HAV IgG and anti-HEV IgG with commercial assays. The seroprevalence of anti-HAV was 11.8%; anti-HEV were detected in 60.9% of BDs (p < 0.0001). Consumption of risky food was more common in anti-HEV-positive BDs (59.1% vs. 33.3%; p = 0.01). Twelve out of 20 BDs (60%) with no

Maciej Bura, Małgorzata Łagiedo-Żelazowska, Michał Michalak, Jan Sikora, Iwona Mozer-Lisewska

Polish Journal of Microbiology, Volume 67 , ISSUE 1, 113–115

Report | 06-November-2019

Drug-induced immune hemolytic anemia: the last 30 years  of changes

Patricia A. Arndt

Immunohematology, Volume 30 , ISSUE 2, 44–54

Article | 18-October-2020

Quantitation of red cell-bound immunoglobulins and complement in lymphoma patients

Quantitative ELISA may be useful for determining the amount of red blood cell (RBC)-associated immunoglobulins (Igs) in patients with autoimmune hemolytic anemia (AIHA). In idiopathic AIHA, there is about 20 times more RBC-associated IgG and complement than in normal persons. In patients with low-grade lymphomas (particularly, B-CLL and splenic marginal zone lymphoma) autoimmune hemolysis is a component of their anemia. In highgrade malignant lymphomas (i.e, diffuse large B-cell lymphoma and

M. Podberezin, A. Levina, L. Romanova, O. Margolin, O. Nasibov, A.V. Pivnik

Immunohematology, Volume 16 , ISSUE 4, 147–153

Article | 28-April-2020

Reactivity of FDA-approved anti-D reagents with partial D red blood cells

of IgM monoclonal anti-D blended with monoclonal IgG anti-D, one IgM monoclonal anti-D blended with polyclonal IgG anti-D, and two reagents formulated with human anti-D in a high-protein diluent. One antiD formulated for use by gel column technology was also tested. Direct agglutination tests by tube or gel were strongly positive (scores 9–12), with partial D RBCs of types DII, DIIIa, DIIIb, and DIVa. No reagent anti-D caused direct agglutination of DVI type 1, DVI type 2, or DFR phenotype

W. John Judd, Marilyn Moulds, Gloria Schlanser

Immunohematology, Volume 21 , ISSUE 4, 146–148

Article | 09-November-2020

Immune hemolytic anemia due to diclofenac

, 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

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

Immunohematology, Volume 13 , ISSUE 1, 9–11

Report | 14-March-2020

The significance of a positive DAT in thalassemia patients

The DAT is performed for the detection of antibody or complement on the surface of RBCs. Our institution previously performed DATs on all chronically transfused thalassemia patients before each transfusion episode to detect early alloimmunization. The medical records of all thalassemia patients treated at our institution from 2004 to 2007 were reviewed to determine the significance of the high rate of positive DATs (52.5% of 80 patients). The majority of IgG-reactive DATs were associated with a

Suzanne A. Arinsburg, Donna L. Skerrett, Dorothy Kleinert, Patricia J. Giardina, Melissa M. Cushing

Immunohematology, Volume 26 , ISSUE 3, 87–91

Article | 14-October-2020

The investigation of the significance of a positive direct antiglobulin test in blood donors

Sixty-two samples from 62 donors were investigated to determine the significance of warm IgG autoantibodies that were detected using a gel system during compatibility testing. The presence of autoantibodies on the red cells was confirmed by elution studies. Twelve of 23 strongly positive samples, 7 of 19 moderately positive samples, and 6 of 11 weakly positive samples were studied. The remaining nine samples were found positive during crossmatching, then negative when it was repeated.These nine

Marianna Bellia, John Georgopoulos, Vasilis Tsevrenis, Efrosini Nomikou, Niki Vgontza, I. Kontogpoulous-Griva

Immunohematology, Volume 18 , ISSUE 3, 78–81

Article | 10-November-2020

Anti-Holley detected in a primary immune response

Anti-Holley (Hy) has been reported as an IgG antibody occurring in previously transfused or multiparous black patients. In this case antiHy was identified in a 16-year-old black, primigravida female admitted at 32 weeks gestation because of premature rupture of the membranes. On admission, her blood type was determined to be A2B, D-positive and an antibody screen was negative. A second antibody screen, performed 4 days later, was positive in all three cells. Anti-Hy was subsequently identified

Vicki J. Barrett, M. Margaret O’Brien, John J Moulds, Peggy Spruell, Valerie Jackson, James R. Stubbs

Immunohematology, Volume 12 , ISSUE 2, 62–65

Article | 27-April-2020

On a much higher than reported incidence of anti-c in R1R1 patients with anti-E

solution for tube IATs (15 min at 37°C,anti-IgG),ficin-tube IATs (30 min at 37°C,anti-IgG + anti-C3), and gel IATs (untreated or ficin-treated RBCs or both, anti-IgG gels). LISS-tube or gel IATs with untreated RBCs revealed anti-c in 32 patients with anti-E. When gel-IAT and ficin-pretreated RBCs were used, 21 additional patients with anti-E were found to have anti-c. In samples from 26 R1R1 patients with anti-E,anti-c was not demonstrable by ficin-gel IATs,and in 3 cases,the ficin-gel tests

W. John Judd, Louann R. Dake, Robertson D. Davenport

Immunohematology, Volume 21 , ISSUE 3, 94–96

Original Paper | 09-March-2018

Comparison of Methods Used for the Diagnosis of Epstein-Barr Virus Infections in Children

IFA were found as 100% for seronegative, 100% for acute primary infection, 22.2% for late primary infection, 92.1% for past infection. The rates of agreement between immunoblotting and IFA were found as 80.8% for seronegative, 68.8% for acute primary infection, 55.6% for late primary infection, 86.6% for past infection. The sensitivity of immunoblotting for anti-VCA IgM was identical with ELISA, and higher for anti-VCA IgG, anti-EBNA IgG, anti-EA antibodies, while the specificity of immunoblotting

Nilgun Kasifoglu, Semra Oz, Ener Cagri Dinleyici, Tercan Us, Ozcan Bor, Gul Durmaz, Yurdanur Akgun

Polish Journal of Microbiology, Volume 67 , ISSUE 1, 81–88

Article | 03-November-2020

Paroxysmal cold hemoglobinuria and the elusive DonathLandsteiner antibody

Four patients with paroxysmal cold hemoglobinuria (PCH) illustrate some of the difficulties in making the diagnosis. A 46-year-old male presented with anemia, a weakly positive direct antiglobulin test (DAT) with anti-IgG, a haptoglobin < 0.1 g/L, and a cold autoagglutinin showing anti-P specificity. A 9-year-old female had a 4-day coryzal illness, a 20 g/L fall in hemoglobin over 24 hours, and a haptoglobin < 0.1 g/L; the DAT was positive with anti-C3d. A 3-year-old female was referred

R.J. Sokol, D.J. Booker, R. Stamps

Immunohematology, Volume 14 , ISSUE 3, 109–112

Article | 03-November-2020

The first case of the p phenotype in a Gurkha Nepalese

A serum sample from a Gurkha Nepalese soldier, residing in Hong Kong, was found to cause hemolysis of reagent ABO red cells (RBCs) in the reverse blood grouping test. Subsequent follow-up studies revealed that he was of the p phenotype, with potent anti-PP1Pk that was strongly hemolytic both at room temperature and 37°C. The anti-PP1Pk was composed of IgG and IgM, and its various components were separable.

C.K. Lin, K.H. Mak, C.K. Cheng, C.P. Yang

Immunohematology, Volume 14 , ISSUE 1, 30–32

Article | 06-December-2020

Compatibility testing problems associated with bovine thrombin-treated plasma

Plasma converted to serum by the addition of bovine thrombin prior to compatibility testing agglutinated all donor red cells. This finding prompted an investigation of bovine thrombin-associated incompatibility that showed that (1) thrombin derived from bovine plasma contains IgG antibodies directed against all human red cells, and (2) excess (> 50 units/mL) bovine thrombin used for conversion of plasma to serum may cause hemagglutination and erroneous serologic test results because of the

Rosetta Sue Shirey, Ana B. Ciappi, Thomas S. Kickler, Darrell Triulzi, Paul M. Ness

Immunohematology, Volume 9 , ISSUE 1, 19–21

Article | 15-February-2021

ZZAP treatment of red blood cells

Principle ZZAP is a mixture of a sulfhydryl reagent (dithiothreitol [DTT]) and a proteolytic enzyme (papain or ficin). It was first described by Branch and Petz in their 1982 article in the American Journal of Clinical Pathology.1 ZZAP is used to dissociate IgG and complement from red blood cells (RBCs), an action that neither reagent can achieve alone. According to Branch and Petz, it is believed that ZZAP “reduces interchain disulfide linkages, increasing exposure of the IgG polypeptides to

S.I. Marckwardt

Immunohematology, Volume 35 , ISSUE 1, 9–10

Article | 01-April-2020

Application of gel technology in the serologic characterization of autoantibody in DAT-positive autoimmune diseases

Gel tests are now available for the determination of immunoglobulin classes and subclasses and complement fractions coating RBCs. These tests simplified serologic characterization of autoantibodies in various autoimmune diseases. The aim of this study was to evaluate the use of gel cards in the serologic characterization of autoantibody with regard to the immunoglobulin classes, complement fractions, and IgG subclasses, and the influence of these characteristics on hemolysis. Gel cards were

Sudipta Sekhar Das, Rajendra K. Chaudhary

Immunohematology, Volume 23 , ISSUE 2, 59–62

Article | 14-October-2020

MIMA-9, a valuable antibody for screening for rare donors

, McLeod, or Ge:–3 red blood cells (RBCs), was used in MTS gel cards containing anti-mouse IgG as the second antibody to test 1134 K– donors. Among the 1134 donors tested, we found one Kp(a+b–) and one Ge:–2,–3,4 donor. If random donor samples had been used instead of preselecting for K–, we would have expected to identify two K+k– donors. One reagent (MIMA-9) can be used to simultaneously screen for K+k–, Kp(a+b–), K0, McLeod, and Ge:–3 RBCs

Edith Tossas, Ragnhild Øyen, Gregory R. Halverson, Harry Malyska, Marion E. Reid

Immunohematology, Volume 18 , ISSUE 2, 43–45

Article | 31-December-2020

An Example of Mild Hemolytic Disease of the Newborn Caused by Anti-Cob

A woman whose serum contained multiple alloantibodies delivered a full-term infant with mild hemolytic disease of the newborn. The direct antiglobulin test performed on the cord cells was positive with monospecific anti-IgG. An acid elution performed on the cord cells yielded anti-Cob. These findings were consistent with the presence of anti-Cob in the maternal serum. Neonatal clinical findings showed a mildly affected infant who demonstrated a moderate rise in total bilirubin and slight

Nancy B. Steffey, Mary A. Lieb

Immunohematology, Volume 3 , ISSUE 1, 9–10

Article | 18-October-2020

Red blood cell diluent composition is important for detection of some anti-E

Commercially prepared 0.8% reagent red blood cells (RBCs) eliminate the need to manually dilute 3 to 5% RBCs for use in gel cards. Ortho-Clinical Diagnostics investigated twelve anti-E samples detected in MTS Anti-IgG gel cards using Ortho 3% reagent RBCs manually diluted to 0.8% in MTS Diluent 2™ (MTS2) that were not detected with commercially prepared Ortho 0.8% reagent RBCs. In gel tests, using additional examples of E-positive RBCs, 22 of 26 antiE were reactive when the cells were

Dania D. Yaskanin, Janice L. Jakway, David J. Ciavarella

Immunohematology, Volume 16 , ISSUE 4, 142–146

Article | 01-April-2020

Differences in ABO antibody levels among blood donors: a comparison between past and present Japanese,Laotian,and Thai populations

environmental factors rather than hereditary factors. In the present study, the anti-A and anti-B titers of random donors in three Asian populations are compared. In Thailand,the IgM anti-A and anti-B titers are low and are similar to the Japanese titers reported in 2001, but the IgG anti-A and anti-B titers are high and are similar to the Japanese titers reported in 1986. In the Lao People’s Democratic Republic,both the IgM and the IgG anti-A and anti-B titers are high and are similar to those

Toshio Mazda, Kenji Tadokoro, Ryuichi Yabe, Oytip NaThalang, Te Thammavong

Immunohematology, Volume 23 , ISSUE 1, 38–41

Article | 16-November-2020

Characterization of human anti-hrB-like monoclonal antibody

To develop a blood typing reagent with Rh specificity, peripheral blood lymphocytes were isolated from a multiparous woman with apparent alloanti-Ce and fused with FIS heteromyeloma cells. One hybridoma cell line, FOR-2E3, secreted human IgG, which agglutinated all human red blood cells except R2R2, RZRZ, Dc–, D––, Rhnull, and e+ hrB–. The supernatant is useful as a reagent to screen for hrB– blood donors and to differentiate haplotypes with C and e in cis from

Antoine P. Blancher, Marion E. Reid, Simone J. Alié-Daram, Jean Michel H. Dugoujon, Francis L. Roubinet

Immunohematology, Volume 12 , ISSUE 3, 119–122

Article | 03-November-2020

Use of LOR-15C9 monoclonal anti-D to differentiate erythrocytes with the partial DVI antigen from those with other partial D antigens or weak D antigens

Historically, red blood cells (RBCs) with partial D antigens have been defined serologically by their pattern of reactivity with polyclonal and monoclonal anti-D. Although numerous variants have been described in tests with well-characterized monoclonal anti-D, definition remains difficult to ascertain serologically. RBCs of known partial D type were tested with LOR-15C9 (a monoclonal anti-D) and commercial anti-D by the tube indirect antiglobulin test (IAT), by micro typing system IgG gel

Marion E. Reid, Gregory R. Halverson, Francis Roubinet, P.A. Apoil, Antoine Blancher

Immunohematology, Volume 14 , ISSUE 3, 89–93

Article | 03-November-2020

Autoimmune hemolytic anemia caused by warm-reacting IgM-class antibodies

Warm IgM autoantibodies occur in association with IgG-class and/or IgA-class immunoglobulins in approximately 30 percent of patients with warm-type autoimmune hemolysis. They may be classified as agglutinins or hemolysins, which may be incomplete or complete, depending on in vitro serology; they almost always bind complement. Autoimmune hemolytic anemia solely due to warm IgM autoantibodies is exceedingly rare. We report two cases of the incomplete agglutinin type. The autoantibodies were

R.J. Sokol, D.J. Booker, R. Stamps, S. Sobolewski, A.P. Haynes

Immunohematology, Volume 14 , ISSUE 2, 53–58

Article | 06-December-2020

Serologic investigation of fatal hemolytic anemia associated with a multiple drug history and Rh-like autoantibody

of three chemically similar nonsteroidal anti-inflammatory drugs: tolmetin (Tolectin®), sulindac (Clinoril®), and ketorolac (Toradol®). Only tolmetin and furosemide (Lasix®) antibodies were demonstrable in the patient's serum at the time of her final admission. The patient's serum at final admission contained panagglutinating IgG and IgM antibody with a titer of 1:80 using a pool of R1R1 and R2R2 screening cells. When tolmetin was added to the test system, the titer

Nancy I. Maddox, Debra Futral, Floyd T. Boudreau

Immunohematology, Volume 8 , ISSUE 3, 70–76

Article | 16-October-2019

Utility of chloroquine diphosphate in the blood bank laboratory

Chloroquine diphosphate (CDP) is a helpful tool in the blood bank for two main applications. The most common application is to render direct antiglobulin test–positive red blood cells (RBCs) free from membrane-bound IgG; these treated RBCs can then be used for autologous adsorption and/or to determine the patient’s RBC phenotype. Another common use of CDP is to remove human leukocyte antigens (HLAs) from RBCs to help identify or exclude the presence of antibodies to HLAs expressed

Thandar Aye, Patricia A. Arndt

Immunohematology, Volume 34 , ISSUE 3, 98–102

Article | 02-May-2020

Cefotetan-induced immune hemolytic anemia following prophylaxis for cesarean delivery

Second- and third-generation cephalosporins,notably cefotetan, are increasingly implicated in severe, sometimes fatal immunemediated hemolytic anemia. We describe a 26-year-old woman who developed severe hemolytic anemia 2 weeks after receiving a single prophylactic dose of cefotetan during cesarean delivery. The patient’s DAT was weakly reactive for IgG and her serum reacted with cefotetan-coated RBCs. The antibody had a titer of 4096 by antiglobulin testing.The patient required

Sherry Shariatmadar, Jill R. Storry, Laima Sausais, Marion E. Reid

Immunohematology, Volume 20 , ISSUE 1, 63–66

Short Communication | 04-December-2017

Seroprevalence of Rubella and Cytomegalia in Young Women from Biała Podlaska District

The aim of this study was to analyze the seroprevalence of rubella and cytomegalia among young women. The study included 175 healthy women from the Biała Podlaska District, aged 16 to 35 years. Anti-rubella and anti-CMV IgG were determined by ELISA. 172 (98.3%) study subjects tested positive for rubella antibodies, 1 (0.6%) was seroindeterminate and 2 (1.1%) were seronegative. CMV antibodies were detected in 119 (68.0%) participants; the series included also 1 (0.6%) seroindeterminate and 55

Dorota Plewik, Małgorzata Tokarska-Rodak, Justyna Paszkiewicz, Adam Szepeluk

Polish Journal of Microbiology, Volume 66 , ISSUE 4, 543–545

Case Study | 10-November-2020

Characteristics of anti-Cob in vitro and in vivo: a case study

Serologic and biologic properties of an example of anti-Cob were investigated. The antibody was of the IgG class, and it bound small amounts of complement. It reacted optimally in the albumin-antiglobulin test with little or no enhancement of its reactivity in tests using enzymes. Additional experiments indicated that the Cob antigen is resistant to treatment with chemicals known to destroy other antigens. The antibody caused shortened survival of radiola­beled Co(b+) donor red cells in our

Johannes J.M.L. Hoffmann, Marijke A.M. Overbeeke

Immunohematology, Volume 12 , ISSUE 1, 11–13

Review | 20-March-2020

Historic milestones in the evolution of the crossmatch

” (IgG) blood group antibodies. Coombs’ introduction of the antiglobulin test (1945) made it possible to detect “incomplete” (IgG) antibodies and to develop laboratory methods to identify and transfuse serologically compatible RBCs. During the past 50 years, the antibody screen has evolved to be more effective than the crossmatch for detecting the presence of potential serologic incompatibility and has, in fact, replaced the crossmatch as the key step in pretransfusion

S. Gerald Sandler, Malak M. Abedalthagafi

Immunohematology, Volume 25 , ISSUE 4, 147–151

Article | 15-February-2021

Donath-Landsteiner test

The Donath-Landsteiner (DL) test is a serologic test used to detect the presence of a biphasic hemolysin, seen in patients with paroxysmal cold hemoglobinuria (PCH). The test relies on the characteristic cold binding of an IgG autoantibody with specificity to the P blood group antigen, which causes complement-mediated red blood cell (RBC) lysis when warmed to body temperature. Julius Donath and Karl Landsteiner first described the antibody responsible for this hemolysis in 1904.1 DL antibodies

M. Kilty, T.S. Ipe

Immunohematology, Volume 35 , ISSUE 1, 3–6

Article | 28-April-2020

Autoimmune hemolytic anemia and a further example of autoanti-Kpb

A 65-year-old Caucasian man with myelodysplasia was admitted with autoimmune hemolytic anemia and a Hb of 5.6 g/dL. The patient’s serum contained anti-K; the DAT on the patient’s RBCs reacted 3+ with anti-IgG and 3+ with anti-C3d.K– RBC units were transfused, but there was no sustained increase in Hb level. The samples were referred to the reference laboratory of the National Blood Service. The DAT results remained the same, with anti-K detected only in the serum. An eluate

Edmond Lee, Gordon Burgess, Nay Win

Immunohematology, Volume 21 , ISSUE 3, 119–121

Article | 03-November-2020

The immunoglobulin molecule

Antibodies, or immunoglobulins, have been used for many years in immunohematology and yet the complexity of these molecules is rarely considered. This review concentrates on IgG and IgM molecules, as these are most usually found in transfusion laboratories. The basic structure and function of the immunoglobulin molecule are addressed at both the protein and the gene level, and isotypes, allotypes, and idiotypes are introduced. Although the antibody molecules secreted by each B cell have a

Janet Sutherland

Immunohematology, Volume 14 , ISSUE 1, 12–18

Article | 06-December-2020

Antibody screening and direct antiglobulin testing using BioVueTM column agglutination technology versus standard tube tests

The BioVue™ column agglutination technology (CAT) was evaluated simultaneously with standard tube test (STT) methodology for use in indirect antiglobulin testing (IAT) and direct antiglobulin testing (DAT). One thousand thirty-five blood specimens were used for the IAT comparison, and 44 blood specimens were used for the DAT comparison. Both polyspecific antiglobulin and anti-IgG antiglobulin reagents were used in the tube testing and the CAT testing. For IAT, sensitivity was 100 percent

Susan F. South

Immunohematology, Volume 9 , ISSUE 3, 78–80

Article | 15-February-2021

Serologic problems associated with administration of intravenous immune globulin (IVIg)

Introduction Preparations of intravenous immune globulin (intravenous gamma globulin; IVIg) are produced from large pools of donor plasma. One lot of IVIg is produced by pooling the plasma of up to 60,000 donors.1,2 IVIg was first produced in the 1970s after the development of the cold alcohol fractionation process (Cohn fractionation) of antibodies from pooled plasma; the final product contains mostly IgG.3–6 The original use for IVIg was as antibody replacement for patients, mostly children

D.R. Branch

Immunohematology, Volume 35 , ISSUE 1, 13–15

Article | 30-November-2020

Autoimmune hemolysis following transfusion: a mimicking autoanti-D in a D- patient with alloanti-D

An 80-year-old group O, D- (rr) female with anti-C, -D, -E, and -Fya received four units of crossmatch-compatible red blood cells (RBCs). The direct antiglobulin test (DAT) was negative. Two weeks later, jaundice, dark urine, a 16% drop in hematocrit (Hct), a 20% reticulocyte count, and absent haptoglobin occurred. During the next month, her DAT was positive with anti-IgG and -C3d. Acid eluates, which repeatedly showed anti-D specificity, were nonreactive with enzyme-treated D- RBCs. Adsorption

Walter H. Dzik, Joyce Blank, Paula Lutz, Thomas G. Hirose, Christine Lomas-Francis, Marilyn Moulds

Immunohematology, Volume 10 , ISSUE 4, 117–119

Original Paper | 04-December-2017

Physiological Effects of Whey- and Milk-Based Probiotic Yogurt in Rats

In an in vitro experiment commercially available probiotic products were tested for the survival of bacteria under conditions of simulated human digestion either when used alone or mixed into yogurt. In the in vivo experiment the effects of feeding a whey- and milk-based yogurt prepared with the probiotic strain showing adequate survival in the in vitro experiment, was measured on body weight, feed con­sumption and immune response of rats (IgG and IgA level after immunisation), on the

Judit Szabó-Fodor, András Bónai, Brigitta Bóta, Linda Szommerné Egyed, Ferenc Lakatos, Gréta Pápai, Attila Zsolnai, Róbert Glávits, Katalin Horvatovich, Melinda Kovács

Polish Journal of Microbiology, Volume 66 , ISSUE 4, 483–490

Case report | 14-October-2020

Autoanti-D in a patient after cladribine treatment for lymphoplasmocytic lymphoma

We report the case of a 62-year-old woman who developed an autoanti-D after cladribine treatment. In May 2000, the patient underwent splenectomy for a stage IV-B lymphoplasmocytic lymphoma. She was transfused with ABO- and Rh(D)-matched blood. A month later, she received chemotherapy with cladribine. In February 2001, blood grouping showed her to be AB, D+ and the direct antiglobulin test was positive for IgG. An autoanti-D was identified in the eluate. Genotypic analysis confirmed the Rh

Joan Cid, Victor Beltran, L. Escoda, Enric Elies, Carmen Martin-Vega

Immunohematology, Volume 18 , ISSUE 1, 16–18

Article | 14-October-2020

Evaluation of a new solid-phase immunoassay for alloantibody detection using bromelin-treated and untreated red blood cells

detected with enzyme-treated intact RBCs and untreated RBCs by M-MPHA. The slight increase in reactivity using M-MPHA was not seen using dried RBC stroma (M-MPHA-Dry). All donor-derived IgG alloantibodies, which were detected by either a conventional tube enzyme test or an indirect antiglobulin test, were detected by M-MPHA without using enzyme-treated RBCs. Both M-MPHA and M-MPHA-Dry can be used for antibody detection without using enzyme-treated RBCs and are also useful for antibody identification.

Toyohiro Tamai, Toshio Mazda

Immunohematology, Volume 17 , ISSUE 1, 17–21

Article | 03-November-2020

Warm autoimmune hemolytic anemia associated with an IgM autoanti-Ge

A 28-year-old male with a prior history of Hodgkin’s disease and a recent upper respiratory tract infection presented with autoimmune hemolytic anemia (AIHA). The patient’s red blood cells (RBCs) were spontaneously agglutinated after room temperature and 37°C washes. Dithiothreitol-treated RBCs reacted strongly with anti-C3 and were nonreactive with anti-IgG, -IgM, and -IgA; they reacted with anti-IgM (κ light chains only) by flow cytometry. The patient’s serum was

Thom S. Sererat, Douglas W. Veidt, Patricia A. Arndt, George Garratty

Immunohematology, Volume 14 , ISSUE 1, 26–29

Case report | 16-November-2020

Case report: rapid onset of severe anemia in childhood. A systematic approach to laboratory diagnosis

Evaluation of a patient prompted the systematic review of causes of abrupt onset anemia in children and the development of a protocol for the immunohematologic workup of such cases. The patient, a 3- year-old boy, presented to our institution two weeks following a viral illness with gross hematuria, jaundice, and severe anemia (hematocrit 14.5%). He was found to have a positive direct antiglobulin test (DAT) due to primarily complement sensitization (2+) with smaller amounts of IgG (weak). A

Linda A. Chambers

Immunohematology, Volume 12 , ISSUE 3, 108–111

Article | 06-December-2020

Reactive lysis - a phenomenon of delayed hemolytic transfusion reactions

posttransfusion, a mixed-field anti-IgG direct antiglobulin test (DAT) indicated that there were two cell populations present. The DAT remained positive with anti-C3b, -C3d throughout the course of the reaction. Because of the substantially lower Hb and the severity of symptoms, immunologic clearance of the antigen-positive donor RBCs was expected. However, we demonstrated their persistence. Our data corroborates the observation that complement activation occurring during DHTRs can result in the hemolysis of

Deborah L. Greene, Sanobar Khan

Immunohematology, Volume 9 , ISSUE 3, 74–77

Article | 14-December-2020

Typing of normal and variant red cells with ABO, Rh, and Kell typing reagents using a gel typing system

superior to most commercially available reagents. Five hundred and thirty samples were typed for Rh antigens. One hundred and twenty-seven of these were of various D category III through VII types (Dcats) and 154 were DUs. The gel system detected all but seven DVI variants and seven DUs. The seven DVI variants, from individuals with no anti-D in their sera, gave reactions identical to the seven DUs when tested against a panel of over 50 monoclonal IgG and IgM anti-Ds. The 554 samples

Don Tills, Derek J. Ward, Dieter Josef

Immunohematology, Volume 7 , ISSUE 4, 94–97

Article | 09-November-2020

A clinically significant anti-HLA-A2 detectable by extended incubation cytotoxicity and flow cytometric techniques but not by a standard NIH lymphocytotoxicity test

the amount of IgG antibodies and the appearance of an IgM component. Such clinically important HLA antibodies can be detected by extended incubation cytotoxicity and flow cytometric assays prior to becoming reactive in a standard NIH cytotoxicity technique.

Stephen F. Garner, John Petrochilos, Colin J. Brown, Suzette Cavanna, I. Chanarin, Cristina Navarrete

Immunohematology, Volume 13 , ISSUE 2, 49–53

Article | 22-November-2020

Use of monoclonal Jka and Jkb reagents in phenotyping red cells with a positive direct antiglobulin test

Twenty-five red cell samples with a positive anti-IgG direct antiglobulin test QAT) were tested with human monoclonal IgM Jka and Jkb antibodies. Red cell samples were first tested by a 5- minute incubation tube test with the monoclonal antibodies (MAbs). The same red cells were then chloroquine diphosphate (CDP)-treated, and retested. Eleven of the CDP-treated samples were also tested with conventional polyclonal antibodies (PAhs) that required a 37°C incubation for 30 minutes, followed by

Judy L. Brazell

Immunohematology, Volume 10 , ISSUE 1, 16–18

Article | 20-December-2020

Two cases of autoantibodies that demonstrate mimicking specificity in the Duffy blood group system

Two transfused Caucasian patients presented with possible delayed transfusion reactions. Both patients demonstrated an anti-Fya (Fy1) plus anti-Fyb (Fy2) pattern of reactivity in their sera. The patients’ red blood cells (RBCs) were Fy:1,-2,3. Both had positive direct antiglobulin tests (DAT) with anti-IgG and -C3d. The serum antibodies reacted with the patients’ RBCs drawn when the DATs were negative. Both patients’ serum samples showed reactivity with Fy:1,-2 (1+), Fy:-1,2

Teresa Y. Harris

Immunohematology, Volume 6 , ISSUE 4, 87–91

Article | 31-December-2020

Cold Autoimmune Hemolytic Anemia With Auto-Anti-AI Specificity: 51Chromium Studies

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

May H. McGinniss, Richard J. Davey, Richard A. Binder, Arthur N. Kales

Immunohematology, Volume 3 , ISSUE 2, 20–22

Case report | 26-October-2019

Blocked D phenomenon and relevance of maternal  serologic testing

A blood requisition for double-volume exchange transfusion was received for a 2-day-old male child born to a 29-yearold multiparous female (P2002) referred to our institute having neonatal jaundice with encephalopathy; no maternal sample was received. The neonatal blood sample was typed as group A, D–, and the direct antiglobulin test (DAT) was strongly positive (4+) using the gel method. Mono-specific DAT showed the presence of IgG antibodies on neonatal red blood cells (RBCs). Acid

Ashish Jain, Vijay Kumawat, Neelam Marwaha

Immunohematology, Volume 31 , ISSUE 3, 116–118

review-article | 15-October-2020

Neuromyelitis optica spectrum disorder: an overview

kidneys etc., its expression is highest in the CNS, particularly in the astrocytic foot processes of optic nerve, spinal cord and brain regions such as area postrema, hypothalamus etc. (Neely et al., 1999; Matiello et al., 2013; Gleiser et al., 2016). AQP4 is required for the clearance of interstitial water, waste and various soluble proteins in the brain (Nagelhus and Ottersen, 2013; Mitsdoerffer et al., 2013). In most NMOSD patients, AQP4 is targeted by self-reactive immunoglobulin G (IgG

Pooja Ramakrishnan, Devipriya Nagarajan

Acta Neurobiologiae Experimentalis, Volume 80 , ISSUE 3, 256–272

Review | 01-December-2019

P1PK: The blood group system that changed its name and expanded

The antigens in the P1PK blood group system are carried on glycosphingolipids. The system currently includes three different antigens, P1, Pk, and NOR. The P1 antigen was disovered in 1927 by Landsteiner and Levine, and Pk and NOR were described in 1951 and 1982, respectively. As in the ABO system, naturally occurring antibodies of the immunoglobulin (Ig) M or IgG class, against the missing carbohydrate structures, can be present in the sera of people lacking the corresponding antigen. Anti-P1

Åsa Hellberg, Julia S. Westman, Britt Thuresson, Martin L. Olsson

Immunohematology, Volume 29 , ISSUE 1, 25–33

Article | 14-October-2020

Loss of enzyme-sensitive antigens due to the presence of leukocytes, neomycin sulfate, and LISS

the cause. Tests were performed according to the manfacturer’s instructions in MTS neutral gel cards or gel cards containing anti-IgG. We found that a reduction or loss of the Fya , Fyb , and M antigens occurs when RBCs were prepared from samples containing residual WBCs (as a source of enzymes) and subsequently incubated in media containing neomycin sulfate and LISS. We showed that the effect did not occur in the absence of neomycin sulfate. RBC antigens can be altered in LISS if they have

Randall W. Velliquette, Paula Howard, Harry Malyska, Marion E. Reid

Immunohematology, Volume 19 , ISSUE 4, 109–111

Article | 26-October-2020

EDTA/glycine-acid versus chloroquine diphosphate treatment for stripping Bg antigens from red blood cells

EDTA/glycine-acid (EGA) has been reported to remove IgG-bound antibodies from red blood cells (RBCs) and to denature Kell system and Era antigens. EGA-treated RBCs were tested in parallel with chloroquine diphosphate (CDP)-treated RBCs to evaluate whether EGA would remove Bg antigens from RBCs as efficiently as CDP. Fifty-seven serum/plasma samples containing known Bg antibodies were tested with untreated Bg+ RBCs, EGA-treated Bg+ RBCs, and CDP-treated Bg+ RBCs by an indirect antiglobulin test

Kayla D. Champagne, Peggy Spruell, Jane Chen, Leslie Voll, Gloria Schlanser

Immunohematology, Volume 15 , ISSUE 2, 66–68

Article | 03-November-2020

Rapid screening of platelet donors for PlA1 (HPA-1a) alloantigen using a solid-phase microplate immunoassay

effectiveness of a solid-phase microplate immunoassay for this purpose. Platelet-rich donor plasmas were tested using the Capture-P® kit (Immucor, Norcross, GA). Platelet monolayers in microtiter wells were incubated with anti-PlA1, washed, and exposed to red blood cells (RBCs) precoated with anti-human IgG. Adherence of RBCs in a diffuse pattern across the well surface indicated the attachment of anti-PlA1 to PlA1-positive platelets whereas sedimentation of unattached RBCs into a central pellet

Jo L. Procter, Faye E. Vique, Ed Alegre, Junichi Honda, Kazuhiko Matsuo, Diane Reid

Immunohematology, Volume 14 , ISSUE 4, 141–145

Article | 09-November-2020

Delayed hemolytic transfusion reaction and paroxysmal cold hemoglobinuria: an unusual association

An 80-year-old female presented with melena and anemia due to bleeding from a benign gastric ulcer. Her blood group was O, D+. The serum contained anti-B and a weak anti-A (titer 2 at 18°C). She was inadvertently transfused with approximately 3.5 units of group A red blood cells with no initial ill effects. One week later, the antiA titer increased to 8 and the direct antiglobulin test (DAT) was weakly positive (IgG and C3d). The next day, intravascular hemolysis became evident. The DAT was

M.A. Wodzinski, R.C. Collin, D.J. Booker, R. Stamps, J.D. Bellamy, R.J. Sokol

Immunohematology, Volume 13 , ISSUE 2, 54–57

Article | 17-November-2020

Acute hemolysis due to passively transfused high-titer anti-B causing spontaneous in vitro agglutination

laboratory investigation revealed the presence of an anti-B antibody coating the infant’s RBCs. Follow-up testing of the O, D- donor serum revealed an anti-B titer of 16,384 (saline) and >64,000 with monospecific anti-IgG. A second uneventful double exchange was performed using washed group O, D- RBCs resuspended in 5 percent albumin.

Gregg Boothe, Mark E. Brecher, Mamie B. Root, Judy Robinson, Nancy R. Haley

Immunohematology, Volume 11 , ISSUE 2, 43–45

Article | 06-December-2020

Anti-Uz found in mother's serum and child's eluate

(DAT) and the autocontrol were negative. Her serum reacted stronger with S+ RBCs only in the antiglobulin phase, and failed to react with U- or ficin-treated RBCs. The antibody was adsorbed completely by S-s+U+ RBCs, proving that anti-S was not present. Monocyte monolayer assay results with S+s-U+ and S-s+U+ RBCs indicated that transfusion of incompatible blood would not result in significant hemolysis. The child's cord RBCs typed S-s+. The DAT was 3+ with anti-IgG, and an eluate prepared from

Sandra M. Read, Mary M. Taylor, Marion E. Reid, Mark A. Popovsky

Immunohematology, Volume 9 , ISSUE 2, 47–49

Article | 15-April-2020

Update on HDFN: new information on long-standing controversies

Hemolytic disease of the fetus and newborn (HDFN) results from maternal IgG antibodies that cross the placenta to the fetal circulation during gestation and cause RBC destruction and complications before birth (HDF), or anemia and hyperbilirubinemia after birth (HDN), or both. In its most severe form,HDF produces hydrops fetalis,which is characterized by total body edema,hepatosplenomegaly,and heart failure and can lead to intrauterine death. Before discovery of Rh immunoglobulin (RhIG), HDFN

Anne F. Eder

Immunohematology, Volume 22 , ISSUE 4, 188–195

Article | 16-November-2020

The GLAM test: a flow cytometric assay for the detection of leukocyte antibodies in autoimmune neutropenia

-positive lymphocytes in the absence of granulocyte-bound IgG, despite a presumed diagnosis of autoimmune neutropenia, rather than pancytopenia. This was the only patient in this cohort who had demonstrable leukocyte antibodies reacting with lymphocytes but not granulocytes. Of the remaining eight patients (not evaluable for granulocyte or lymphocyte DATs), five had free leukocyte antibodies in the serum; three of these five had both granulocyte- and lymphocyte-reactive antibodies free in the serum and

Anatole Lubenko, Sally Rosemary Wilson

Immunohematology, Volume 12 , ISSUE 4, 164–168

Article | 10-November-2020

Autoimmune hemolytic anemia due to IgA class autoantibodies

Autoimmune hemolytic anemia due to warm-reacting autoantibod­ies solely of the IgA class is very rare, and only five cases were iden­tified among 5,177 patients referred during 13.5 years. All were females (ages 21-69 years) and all presented with idiopathic “Coombs negative’ autoimmune hemolytic anemia, a diagnosis that was confirmed using monospecific anti-human IgA reagents. Red cell-bound IgG was reduced, but in two patients IgM was initially increased, an occurrence

R.J Sokol, D.J Booker, R. Stamps, J.R. Booth

Immunohematology, Volume 12 , ISSUE 1, 14–19

Report | 26-October-2019

Comparative evaluation of gel column agglutination and erythrocyte magnetized technology for red blood cell alloantibody titration

Antibody titration is traditionally performed using a conventional test tube (CTT) method, which is subjected to interlaboratory variations because of a lack of standardization and reproducibility. The aim of this study is to compare newer methods such as gel column technology (GCT) and erythrocyte magnetized technology (EMT) for antibody titration in terms of accuracy and precision. Patient serum samples that contained immunoglobulin G (IgG) red blood cell (RBC) alloantibodies of a single

Anju Dubey, Atul Sonker, Rajendra K. Chaudhary

Immunohematology, Volume 31 , ISSUE 1, 1–6

Article | 09-November-2020

Clinical significance of an anti-Dib assessed by flow cytometry

, 7, and 10, the percent of circulating Di(b+) RBCs was determined to be 39, 30, and 11 percent, respectively, compared to an expected 49, 43, and 41 percent based on calculations. The Di(b+) RBCs appear to have been tolerated for about 6 days, then were removed from the circulation. Direct anti-IgG tests were 1–2+ mixed field with all posttransfusion samples. Monocyte monolayer assays (MMAs), which have been reported to predict the clinical significance of alloantibodies, gave borderline

Regina M. Leger, Patricia A. Arndt, Asuncion Co, Lauren O’Brien, George Garratty

Immunohematology, Volume 13 , ISSUE 3, 93–96

Case report | 01-December-2019

Performance of an automated solid-phase  red cell adherence system compared with  that of a manual gel microcolumn assay for  the identification of antibodies eluted from  red blood cells

IgG antibodies coating red blood cells (RBCs) can be removed by elution procedures and their specificity determined by antibody identification studies. Although such testing is traditionally performed using the tube agglutination assay, prior studies have shown that the gel microcolumn (GMC) assay may also be used with comparable results. The purpose of this study was to compare an automated solid-phase red cell adherence (SPRCA) system with a GMC assay for the detection of antibodies eluted

Rachel H. Finck, Rebecca J. Davis, Shih-Mao Teng, Dennis Goldfinger, Alyssa F. Ziman, Qun Lu, Shan Yuan

Immunohematology, Volume 27 , ISSUE 1, 1–5

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