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  • Immunohematology

 

Article | 09-November-2020

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

diagnosis of autoimmune hemolytic anemia (AIHA). Red cell transfusions and corticosteroids were given with eventual complete recovery. A 73-year-old male had a hemoglobin of 89 g/L and haptoglobin of < 0.1 g/L. The DAT was initially negative but was positive for IgG using cold-washed (4°C) RBCs; it was also positive with unwashed cells in the DiaMed system and an eluate contained IgG1 autoantibody. AIHA was therefore confirmed and prednisolone started but continued hemolysis necessitated

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

Immunohematology, Volume 13 , ISSUE 4, 115–118

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

Case report | 09-October-2019

Autoanti-C in a patient with primary sclerosing cholangitis and autoimmune hemolytic anemia: a rare presentation

Primary sclerosing cholangitis (PSC) is rarely associated with autoimmune hemolytic anemia (AIHA), and the presence of  specific autoantibodies has not been reported previously. We present a unique case report of PSC associated with AIHA implicating autoanti-C. A 17-year-old girl was admitted to our hospital with PSC along with AIHA. Her blood sample demonstrated a positive direct antiglobulin test and a positive autocontrol in the antihuman globulin phase, confirming the patient had warm

Meenu Bajpai, Ashish Maheshwari, Shruti Gupta, Chhagan Bihari

Immunohematology, Volume 32 , ISSUE 3, 104–107

Article | 14-October-2020

Clinically significant autoimmune hemolytic anemia with a negative direct antiglobulin test by routine tube test and positive by column agglutination method

In two to five percent of cases of autoimmune hemolytic anemia (AIHA),the patient’s RBCs are negative in the direct antiglobulin test (DAT). We describe a patient with AIHA with a negative DAT when tested by the traditional tube test but with a strongly positive one when tested by column agglutination. When the DAT was repeated by tube test using 4°C saline washes, it became positive. This phenomenon has been observed when low-affinity antibodies are involved in AIHA. The patient

Marco Lai, Carlo Rumi, Giuseppe D’Onofrio, Maria Teresa Voso, Giuseppe Leone

Immunohematology, Volume 18 , ISSUE 4, 109–113

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 | 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

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

Review | 28-April-2020

Review: complement receptor 1 therapeutics for prevention of immune hemolysis

anemia (AIHA). Complement receptor 1 (CR1) is a large single-pass glycoprotein that is expressed on a variety of cell types in blood, including RBCs and immune cells. Among its multiple functions is its ability to inhibit complement activation. Furthermore, gene knockout studies in mice implicate a role for CR1 (along with the alternatively spliced gene product CR2) in prevention of autoimmunity. This review discusses the possibility that the CR1 protein may be manipulated to prevent and treat AIHA

Karina Yazdanbakhsh

Immunohematology, Volume 21 , ISSUE 3, 109–118

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

Review | 01-December-2019

Allogeneic red blood cell adsorption for removal of warm autoantibody

Christina Barron

Immunohematology, Volume 30 , ISSUE 4, 153–155

Article | 22-January-2021

A case of megaloblastic anemia simulating a cold autoimmune hemolytic anemia

diagnostic suspicion of AIHA. The patient did not present with fever, cough, dyspnea, weight loss, or other AIHA-associated symptoms except for a few days of asthenia. There was no history of drug intake and no recent ongoing alcohol abuse, but she explained inappropriate dietary intake. She had no family history of PA. On admission, the patient (height 160 cm and body weight 75 kg) was faintly icteric and pale. Initial hemoglobin (Hb) value was 6.9 g/dL (normal 12–16 g/dL) but worsened in the following

R. De La Puerta, N. Carpio, G. Sanz, P. Solves

Immunohematology, Volume 36 , ISSUE 3, 89–92

Case report | 16-May-2020

Case report: exacerbation of hemolytic anemia requiring multiple incompatible RBC transfusions

RBC transfusions in a patient with a history of autoimmune hemolytic anemia (AIHA) can represent both a laboratory and a clinical challenge. The development of high-titer low-avidity antibodies and antibodies to high-frequency antigens may further impair the ability to identify compatible donor RBCs. Not infrequently, incompatible RBCs must be used and the desire to increase oxygen carrying capacity conflicts with the desire to avoid exacerbating the autoimmune hemolytic process with RBC

Annika M. Svensson, Sharon Bushor, Mark K. Fung

Immunohematology, Volume 20 , ISSUE 3, 177–183

Article | 10-November-2020

Leukocyte reduction of red cells when transfusing patients with autoimmune hemolytic anemia: a strategy to decrease the incidence of confounding transfusion reactions

Autoimmune hemolytic anemia (AIHA) presents a difficult challenge to clinicians and blood bankers alike. Autoantibodies in the serum significantly complicate serologic evaluation, and necessitate performing procedures such as adsorptions to eliminate the possibility of underlying alloantibodies. In many instances the blood that is issued may be phenotypically similar but remains crossmatch incompatible, generating a considerable degree of anxiety among the clinical staff who are responsible for

Jeanne A. Lumadue, Rosetta Sue Shirey, Thomas S. Kickler, Paul M. Ness

Immunohematology, Volume 12 , ISSUE 2, 84–86

Article | 18-October-2020

Frequency of HLA-DQB*06 in Caucasian, African American, and Mexican American patients with a positive direct antiglobulin test

Joann M. Moulds, Laura A. Diekman, T. Denise Wells, John D. Reveille

Immunohematology, Volume 16 , ISSUE 2, 74–77

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