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  • Immunohematology


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

Review | 22-November-2020

Review: immune hemolytic anemia and/or positive direct antiglobulin tests caused by drugs

George Garratty

Immunohematology, Volume 10 , ISSUE 2, 41–50

Article | 06-December-2020

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

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

Immunohematology, Volume 8 , ISSUE 1, 13–16

Report | 29-October-2019

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

Ashutosh Singh, Archana Solanki, Rajendra Chaudhary

Immunohematology, Volume 30 , ISSUE 1, 24–27

Article | 27-December-2020

Current viewpoints on mechanisms causing drug-induced immune hemolytic anemia and/or positive direct antiglobulin tests

George Garratty

Immunohematology, Volume 5 , ISSUE 4, 97–106

Article | 14-October-2020

Nondetection of the S antigen due to the presence of sodium hypochlorite

Anne Long, Lyne Tremblay, Lucie Richard, Réal Lemieux, Mindy Goldman

Immunohematology, Volume 18 , ISSUE 4, 120–122

Article | 17-November-2020

LISS-dependent autoantibody with apparent anti-U specificity

Nonspecific binding of gamma globulin and complement, resulting in falsely positive indirect antiglobulin tests, has occurred with use of low-ionic strength saline solution (LISS) reagents. These LISS-dependent antibodies have not been described in association with any particular disease state, nor do they have any apparent clinical significance. We present a LISS-dependent antibody with apparent autoanti-U specificity.

J.T. Chiofolo, M.E. Reid, D. Charles-Pierre

Immunohematology, Volume 11 , ISSUE 1, 18–21

Report | 06-November-2019

Drugs that have been shown to cause druginduced immune hemolytic anemia or positive direct antiglobulin tests: some interesting findings since 2007

George Garratty, Patricia A. Arndt

Immunohematology, Volume 30 , ISSUE 2, 66–79

Article | 18-October-2020

From kill to overkill: 100 years of (perhaps too much) progress

Peter D. Issitt

Immunohematology, Volume 16 , ISSUE 1, 18–25

Article | 03-November-2020

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

confirmed as IgM by their ability to rebind to normal red blood cells (RBCs) after elution; the absence of small increases in RBC-bound IgG and IgA was shown by a sensitive enzyme-linked antiglobulin test. Patient 1 was a 64-year-old female with non-Hodgkin’s lymphoma, with a hemoglobin of 50 g/L and haptoglobin of < 0.1 g/L. Direct antiglobulin tests were positive for IgM, C3d, and C3c; only IgM was present in an eluate. The serum contained a weak autoantibody at 37°C and tests for

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

Immunohematology, Volume 14 , ISSUE 2, 53–58

Article | 03-November-2020

Implementation of gel column technology, including comparative testing of Ortho ID-MTS with standard polyethylene glycol tube tests

With the intent to increase laboratory efficiency and according to the Clinical Laboratory Improvement Act of 1988 (CLIA ’88), a parallel testing program comparing traditional tube technology with the gel system technology was undertaken. Test tube indirect antiglobulin tests were performed using polyethylene glycol (PEG) as the antibody enhancement medium. Gel (GEL) column technology used the ID-Micro Typing System™, using predispensed anti-IgG and lowionic-strength saline for

Diane A. Derr, Stacy J. Dickerson, E.Ann Steiner

Immunohematology, Volume 14 , ISSUE 2, 72–74

Article | 03-November-2020

GIL: a red cell antigen of very high frequency

A new high-frequency red cell antigen has been identified and named GIL. GIL differs from all high-frequency antigens included in the International Society of Blood Transfusion classification. There is very little family information and GIL has not been shown to be an inherited character. Five women with anti-GIL have been found. All had been pregnant at least twice. Red blood cells of two of the babies gave positive direct antiglobulin tests, but there were no clinical signs of hemolytic

Geoff Daniels, E. Nicole DeLong, Virginia Hare, Susan T. Johnson, Pierre-Yves LePennec, Delores Mallory, M. Jane Marshall, Cindy Oliver, Peggy Spruell

Immunohematology, Volume 14 , ISSUE 2, 49–52

Article | 14-October-2020

Anti-Mta associated with three cases of hemolytic disease of the newborn

The Mta antigen is a low-frequency red blood cell (RBC) surface antigen and is an established antigen of the MNSs blood group system. There has been one report of anti-Mta –induced hemolytic disease of the newborn (HDN) in the literature to date. We describe a family in which three children were affected by neonatal anemia. The clinical and hematologic findings were consistent with HDN, despite repeatedly negative direct antiglobulin tests (DAT) on cord RBCs. Serologic investigations

Carol C. Cheung, Daniel Challis, George Fisher, Susan J. Russell, Andrew Davis, Hayley Bruce, Julie Watt, Beng H. Chong

Immunohematology, Volume 18 , ISSUE 2, 37–39

Article | 16-October-2019

Dithiothreitol treatment of red blood cells

C.B. Bub

Immunohematology, Volume 33 , ISSUE 4, 170–172

Article | 15-February-2021

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

anemia.13,17 Thrombosis can also result from IVIg infusion, but this is quite rare compared with IVIg-associated hemolysis.18 In addition to adverse events, administration of IVIg can create challenges for the transfusion service including ABO discrepancies, positive direct antiglobulin tests (DATs), positive antibody detection tests, and incompatible crossmatches. Reverse ABO Grouping Because up to 4 g/kg of IVIg may be given to an individual with blood group A, B, or AB, these patients will often

D.R. Branch

Immunohematology, Volume 35 , ISSUE 1, 13–15

Case report | 01-December-2019

An AQP1 allele associated with Co(a–b–) phenotype

deletion of a G at nucleotide 601 (nt601delG) that results in a frameshift and premature termination (Val201Stop). Available family members were tested for the allele. Although anti-Co3 has been associated with mild to severe hemolytic disease of the fetus and newborn, the antibody was not clinically significant as evidenced by a low titer and delivery of asymptomatic newborns with moderate to weakly positive direct antiglobulin tests for all four pregnancies.

Sunitha Vege, Sandra Nance, Donna Kavitsky, Xiaojin Li, Trina Horn, Geralyn Meny, Connie M. Westhoff

Immunohematology, Volume 29 , ISSUE 1, 1–4

Article | 14-October-2020

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

infusions of IV RhIG in D+ ITP patients, the direct and indirect antiglobulin tests become transiently positive, reflecting passively transferred anti-D and other alloantibodies that were present in the infused IV RhIG. These consistent and predictable serologic findings contrast with the inconsistent and weak anti-D reactivity observed when D– women are treated with relatively small doses of intramuscular RhIG for Rh immunoprophylaxis. The pathophysiology of ITP and the effect of infusing IV RhIG

Can M. Savasman, S. Gerald Sandler

Immunohematology, Volume 17 , ISSUE 4, 106–110

Article | 14-October-2020

Selecting an acceptable and safe antibody detection test can present a dilemma

The Transfusion Service at Duke University Hospital has changed antibody detection methods from the use of albumin in indirect antiglobulin tests to low-ionic-strength solution (LISS), and from LISS to polyethylene glycol (PEG) in an effort to enhance the rapid detection of clinically significant antibodies. In 1996, staffing issues required the consideration of automation. Although previous studies indicated that the gel test was not as sensitive as PEG for detection of clinically significant

Martha Rae Combs, Steven J. Bredehoeft

Immunohematology, Volume 17 , ISSUE 3, 86–89

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 | 16-November-2020

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

patients with a suspected diagnosis of autoimmune neutropenia were referred for investigation. Leukocytes were harvested in sufficient quantities from 10 of the patients such that neutrophil and lymphocyte direct antiglobulin tests (DATs) and antibody screening and identification could be undertaken (in one case the results were inconclusive). Only three of these 10 patients had DAT-positive granulocytes, and one of these three also had DAT-positive lymphocytes. One further patient demonstrated DAT

Anatole Lubenko, Sally Rosemary Wilson

Immunohematology, Volume 12 , ISSUE 4, 164–168

Article | 14-December-2020

Determining the significance of anti-K1 in hemolytic disease of the newborn (HDN)

severely affected infants requiring multiple intrauterine transfusions starting at 20-23 weeks. Six others delivered antigen-positive infants who did not require transfusions, although all had positive direct antiglobulin tests (DATs). We conclude that titration studies are reliable tools to evaluate anti-K1 sensitization when the titer is <32. Cordocentesis can detect antigen-negative fetuses, which then reduces the need for titrations and amniocentesis.

Patricia L. Strohm, Janice F. Blazina, Richard W. O'Shaughnessy, Melanie S. Kennedy, Jane M. Moore

Immunohematology, Volume 7 , ISSUE 2, 40–42

Article | 26-October-2020

Naturally-occurring anti-Jka in infant twins

transfusions. Red blood cells (RBCs) from the patient and her sister typed as Jk(a-b+) by direct hemagglutination and this phenotype was confirmed by negative adsorption and elution studies. Both infants' plasma samples were strongly reactive with 20 examples of Jk(a+) RBCs and nonreactive with 20 examples of Jk(a-) RBCs by SPRCA assays. Anti-Jka was not detected in either twins' plasma by indirect antiglobulin tests by tube method in low-ionic-strength saline solution or polyethylene glycol, or

Dawn H. Rumsey, Sandra J. Nance, Mary Rubino, S. Gerald Sandler

Immunohematology, Volume 15 , ISSUE 4, 159–162

Article | 22-November-2020

Cefotetan-induced immune hemolytic anemia due to the drug-adsorption mechanism

Positive direct antiglobulin tests (DATs) associated with cephalosporin therapy have been reported, but rarely were associated with immune hemolytic anemia (IHA). In 1989, we described the first case of IHA associated with cefotetan (Cefotan™) causing hemolysis by the drug-adsorption mechanism. We now report the full details of our investigation. The patient was a 23-year-old female with a 2 1/2 year history of chronic ulcerative colitis. After 4 days of therapy with cefotetan (2 g/day

Robert J. Eckrich, Susan Fox, Delores Mallory

Immunohematology, Volume 10 , ISSUE 2, 51–54

Article | 14-October-2020

Intravenous Rh immune globulin prevents alloimmunization in D– granulocyte recipients but obscures the detection of an alloanti-K

granulocyte transfusions, 4 and 7 of which, respectively, were D+. Both patients died before the effectiveness of RhIG could be assessed. In one of these patients the indirect and direct antiglobulin tests became positive after the first dose of intravenous RhIG, which required that subsequent granulocyte transfusions from D+ donors be crossmatched by immediate spin (IS) testing only. A delayed hemolytic reaction attributed to alloanti-K occurred after granulocytes from a K+ donor were given to this

D.F. Stroncek, J.L. Procter, L. Moses, C. Bolan, G.J. Pomper, C. Conry-Cantilens, H.L. Malech, H.G. Klein, S.F. Leitman

Immunohematology, Volume 17 , ISSUE 2, 37–41

Review | 13-April-2020

Review: monoclonal reagents and detection of unusual or rare phenotypes or antibodies

rare phenotypes can cause discrepant reactions when performing phenotyping. Discrepant reactions can also occur because of patient or donor antibodies that react in an unusual manner when antiglobulin tests are performed with monoclonal antihuman globulin (AHG) versus rabbit AHG reagent. It is important to know the identity of the unusual or rare phenotypes and antibodies and to be able to recognize the different types of reactions that will be observed when using more than one reagent of the same

Marilyn K. Moulds

Immunohematology, Volume 22 , ISSUE 2, 52–63

Article | 16-October-2019

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

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

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