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Article | 17-February-2021

Elimination of HLA antibodies by platelet adsorption

Introduction HLA antibodies are often a nuisance in antibody investigation and compatibility testing. These antibodies are often found in samples from multiply transfused patients who are refractory to platelet transfusion. They are common in multiparous women and can also develop spontaneously. Before the introduction of leukocyte reduction, HLA antibodies were known as a major cause of febrile transfusion reactions.1 HLA antibody reactivity may mask the presence of clinically significant red

J. Jung, C. Barron

Immunohematology, Volume 36 , ISSUE 1, 1–3

Article | 18-October-2020

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

A reduced frequency of HLA-DQ6 in patients with a positive direct antiglobulin test (DAT) was previously reported but race was undisclosed. Therefore, we investigated a total of 275 patients (80 Caucasian, 113 African American, and 82 Mexican American) and 518 normal controls (205 Caucasian, 208 African American, and 105 Mexican American). These were typed for class II HLA antigens using molecular techniques. A DAT was performed on each patient’s red cells drawn into EDTA using both mouse

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

Immunohematology, Volume 16 , ISSUE 2, 74–77

Article | 20-December-2020

Human leukocyte antigens (HLA) class I (Bg) on red cells studied with monoclonal antibodies

Monoclonal antibodies, capable of detecting monomorphic epitopes on HLA class I polypeptides and beta-microglobulin (ß2-M), have been used by a variety of techniques to ascertain the type of structure detected on red blood cells (RBCs). Hemagglutinatlon with class I monoclonal antibodies confirmed the reported relationship between Bg blood groups and HLA. It also established that the expression of HLA on RBCs which do not have nuclei is not normally strong, hut may be enhanced in patients

Carolyn M. Giles

Immunohematology, Volume 6 , ISSUE 3, 53–58

Case report | 14-October-2020

Case report: four donors with granulocyte-specific or HLA class I antibodies implicated in a case of transfusion-related acute lung injury (TRALI)

. Four of the donors of the implicated units of plasma were female and all had a history of pregnancy. Two donors had HLA class I antibodies and two had granulocytespecific antibodies detectable in their serum. In crossmatch studies, granulocyte-reactive antibodies from two donors bound to granulocytes from the patient, which suggested that these antibodies were clinically relevant. These clinical and serologic findings support a diagnosis of transfusion-related acute lung injury (TRALI).

A. Davoren, O.P. Smith, C.A. Barnes, E. Lawler, R.G. Evans, G.F. Lucas

Immunohematology, Volume 17 , ISSUE 4, 117–121

Article | 26-October-2020

Serologic and molecular investigations of a chimera

A chimeric individual possesses two or more genetically distinct cell populations. Although the chimerism may not be evident in all gene systems, various loci display greater numbers of alleles than genetically "normal" individuals. The proposita was referred for further laboratory investigation due to a rnixed-field ABO blood group reaction following routine antenatal testing. Various molecular (HLA class Il, ABO genotyping, and 10 short tandem repeat [STR] microsatellites) and

Nicole A. Mifsud, Albert P. Haddad, Cathie F. Hart, Jennifer A. Condon, Michael Swain, Rosemary L. Sparrow

Immunohematology, Volume 15 , ISSUE 3, 100–104

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

A previously transfused female patient, known to have a platelet defect, was transfused with platelets prior to surgery. After the 18th unit she felt unwell, developed fever, rigor, became nauseous, and vomited. Her blood pressure decreased from 140/90 to 80/50mm Hg. Passive transfer of donor granulocytes or red cell antibodies were excluded as a cause. Therefore, a serum sample from the patient was investigated for the presence of antibodies to human leukocyte antigens (HLA) using a standard

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

Immunohematology, Volume 13 , ISSUE 2, 49–53

Article | 14-October-2020

False reactivity in GTI Pak Plus® ELISA kits due to the presence of anti-mouse antibody in patients' samples

The development of commercially available ELISA kits (GTI, Inc., Waukesha,WI) that use antigens adhered to microtiter plate wells by the use of mouse monoclonal antibodies made it possible for hospital transfusion service laboratories to test for platelet- and/or HLA-specific antibodies without reliance on reference laboratories. However, human anti-mouse antibodies (HAMAs) may cause false reactions in ELISAs. We designed a study to determine the impact of HAMAs on these ELISAs. Samples from

Miriam Fogg Leach, James P. AuBuchon

Immunohematology, Volume 19 , ISSUE 4, 112–116

Review | 20-March-2020

Recognition and management of antibodies to human platelet antigens in platelet transfusion–refractory patients

Platelet transfusion refractoriness is a problem for parous and multiply transfused patients, placing them at higher risk for morbidity and mortality when posttransfusion count increments are significantly lower than expected. Although nonimmune causes of transfusion refractoriness are very common, HLA alloantibodies are the most important of the less frequent immune factors responsible for inadequate count increments. As universal leukoreduction decreases the occurrence of HLA antibody

Ralph R. Vassallo

Immunohematology, Volume 25 , ISSUE 3, 119–124

Report | 14-October-2020

Development of anti-Bw6 reactivity in patients receiving r-GCSF: a preliminary report

Recombinant granulocyte colony-stimulating factor (r-GCSF) is used in autologous bone marrow/peripheral blood progenitor cell transplantation (ABMT/PBPC) to shorten the period of neutropenia. As these patients require platelet transfusions, their sera may be monitored for the presence of platelet/human leukocyte antigen (HLA) antibodies. Sera of some patients on r-GCSF (16 μg/kg/day) became difficult to evaluate in vitro for the presence of HLA and platelet antibodies because of apparently

Miriam Fogg Leach, James P. AuBuchon

Immunohematology, Volume 17 , ISSUE 3, 63–69

Article | 20-December-2020

Incidence of Rodgers-negative individuals in systemic lupus erythematosus patients

Early reports of anti-Rodgers (anti-Rg) noted that there was an increased number of the HLA-B8 phenotype among this group. This HLA type has recently been linked to a C4A (Rg) gene deletion found with increased frequency among systemic lupus erythematosus (SLE) patients. Healthy controls (n= 176) and SLE patients (n=102) were studied for their HLA haplotype and C4 allotype as well as their Rg phenotype. Six of 53 white and 3 of 49 black SLE patients were C4A-null and Rodgers-negative, a

JoAnn M. Moulds

Immunohematology, Volume 6 , ISSUE 4, 92–94

Article | 16-February-2021

A case of platelet transfusion refractoriness due to anti-CD36 with a successful treatment outcome

, given over this 14-day period, ranged from 0 to 0.82 (Fig. 1). All CCIs reported in Table 1 were calculated from PLT counts within 1 hour after the PLT transfusion. Fig. 1 Types of platelets (PLTs), corrected count increment (CCI), HLA and CD36 antibody levels, and medications for immune suppression over the course. HLA class I panel reactive antibody (PRA), anti-CD36 titer decrease, and CCI increase after the third intravenous immunoglobulin (IVIG) infusion are shown. Table 1. CCI achieved with

S.S. Khatri, B.R Curtis, C. Yamada

Immunohematology, Volume 35 , ISSUE 4, 139–144

Article | 14-December-2020

Paternity evaluation in the presence of splits and crossreactive antigens

Evaluation of paternity (alleged father, mother, and child) can range from a strightforward resolution to a complex problem that cannot be resolved without family studies. We present a case of disputed paternity in which tests for crossreactive groups (CREGs) and antigen subtypes (splits) within the human leukocyte antigen (HLA) system could not be used confidently to prove or disprove paternity. Further analysis, red cell enzyme tests, enabled a final verdict and confirmed the current

Robert W. Gutendorf, Kamala Balakrishnan, David L. Taylor, Kelly Cox

Immunohematology, Volume 7 , ISSUE 2, 43–45

Case report | 09-October-2019

ABO serology in a case of persistent weak A in a recipient following a group O–matched unrelated bone marrow transplant

HLA-matched hematopoietic stem cell transplantation (HSCT) from red blood cell (RBC)-incompatible donors is not uncommon. The engraftment process following ABO-incompatible allogeneic HSCT results in the transition from patient blood group to donor blood group in the recipient. In contrast, most non-hematopoietic tissues retain expression of the patient’s original blood group for life, and these antigens may adsorb from the plasma onto the donor-derived RBCs. Correct serologic

Dianne E. Grey, Elizabeth A. Fong, Catherine Cole, Jesper Jensen, Jill Finlayson

Immunohematology, Volume 33 , ISSUE 3, 99–104

Article | 27-December-2020

Resolution of discrepant typings observed in paternity testing

Discrepant results in phenotyping the red blood cells (RBCs) of a child and his alieged parents were attributable to a contaminating antibody, anti-Bgb (HLA B-17), in typing reagents (anti-C and -CW). This case demonstrates the necessity for using reagents from at least two sources for paternity testing.

Mary Lou Guizzo, Nancy Lang

Immunohematology, Volume 5 , ISSUE 2, 57–59

Article | 20-April-2020

Gene frequencies of the HPA-1 to 6 and Gov human platelet antigens in Thai blood donors

Human platelet alloantigens (HPA) are important in neonatal alloimmune thrombocytopenia (NAIT), posttransfusion purpura (PTP), platelet transfusion refractoriness, passive alloimmune thrombocytopenia, and transplantation-associated alloimmune thrombocytopenia. Thus, HPA genotyping is essential in diagnosis and treatment. We analyzed HPA-1 to 6 and Gov alleles, using PCR with sequence specific primers (PCR-SSP) in 500 Thai blood donors who had been HLA class I antigen typed. HPA-4a was present

Pawinee Kupatawintu, Oytip Nathalang, Rachanee O-Charoen, Pimpicha Patmasiriwat

Immunohematology, Volume 21 , ISSUE 1, 5–9

Article | 26-October-2020

Anti-Lu9: the finding of the second example after 25 years

The first and only reported exanipie of anti-Lu9 (an antibody directed at a low-incidence antigen in the Lutheran blood group system and allelic to the high-incidence antigen Lu6) was described in 1973 in the serum of a white female, Mrs. Mull. Her serum also contained anti-Lul1 (-Lua), and subsequently, an anti-HLA-B7 (-Bga) was identified. We report the second example of anti-Lu9 in a white male (GR), found 25 years later. The GR serum was reactive in the indirect antiglobulin test with Lu

Kayla D. Champagne, Marilyn Moulds, Jo Schmidt

Immunohematology, Volume 15 , ISSUE 3, 113–116

Article | 17-November-2020

Application of the proteolytic enzyme papain in routine platelet serology

, -5a, -5b, and -Naka were examined. HLA antibodies were also included. All sera were tested by a solid-phase red cell adherence technique in parallel with untreated platelets (UP) and platelets treated with papain (PP) for 15 minutes at 37°C. The reactivity of anti-HPA-2b was eliminated and that of anti-HPA-3a was either eliminated or almost eliminated with PP. Antisera specific for the other alloantigens tested reacted similarly or more strongly with PP compared with UP. These findings were

John A.G. Lown, Brian J. Dale

Immunohematology, Volume 11 , ISSUE 4, 140–142

Article | 26-October-2019

An overview of the Progenika ID CORE XT: an automated genotyping platform based on a fluidic microarray system

Automated testing platforms facilitate the introduction of red cell genotyping of patients and blood donors. Fluidic microarray systems, such as Luminex XMAP (Austin, TX), are used in many clinical applications, including HLA and HPA typing. The Progenika ID CORE XT (Progenika Biopharma-Grifols, Bizkaia, Spain) uses this platform to analyze 29 polymorphisms determining 37 antigens in 10 blood group systems. Once DNA has been extracted, processing time is approximately 4 hours. The system is

Mindy Goldman, Núria Nogués, Lilian M. Castilho

Immunohematology, Volume 31 , ISSUE 2, 62–68

Article | 20-December-2020

A simple method for inhibiting ABO antibodies in sera used for platelet crossmatching

Sometimes it is necessary to crossmatch and transfuse ABO-incompatible platelets. As IgG anti-A and anti-B sometimes react with platelets from group A or B donors, these reactions can confuse the interpretation of crossmatching, which is designed to detect HLA or platelet-specific antibodies. Methods previously described to overcome this problem have been complex. Neutr-ABR, which contains A and B blood group substances from porcine and equine sources, can be used to neutralize anti-A and/or

Nina Postoway, George Garratty

Immunohematology, Volume 6 , ISSUE 3, 68–70

Article | 16-November-2020

Rhmod phenotype: a parentage problem solved by denaturing gradient gel electrophoresis of genomic DNA

Initial Rh phenotyping of a man with hemolytic anemia, his wife, and son appeared to exclude paternity. No exclusion was found in other blood groups or in the human leukocyte antigen (HLA) system; excluding Rh, the paternity index was 98.58 percent. Samples from these three family members, and two other family members, were tested with additional Rh antisera. The results indicated that the propositus has an Rhmod phenotype with expression of c, weak e, and very weak D, E, and G antigens. To

Fiona J. Steers, Maura Wallace, Marialuisa Mora, Ben Carritt, Patricia Tippett, Geoff Daniels

Immunohematology, Volume 12 , ISSUE 4, 154–158

Article | 17-November-2020

Trimeresurus venom inhibition of anti-HPA-1a and anti-HPA-1b antibody binding to human platelets

A solid-phase red cell adherence assay was used to demonstrate the specific inhibitory effect of seven species of Trimeresurus snake venom on the binding of HPA-1a- and HPA-1b-specific platelet antibodies. Trimeresurus venom did not inhibit the binding of HLA-, HPA-3a-, HPA-3b-, HPA-4a-, HPA-5a-, and HPA-5b-specific platelet antibodies. Venom from other genera of snakes, including representatives from Agkistrodon, Ancistrodon, Bitis, Bothrops, Bungarus, Causus, Crotalus, Dendroaspis, Ecis

Steve J. Wlodar, Darryl L. Stone, Lyle T. Sinor

Immunohematology, Volume 11 , ISSUE 4, 129–132

Article | 14-October-2020

Significance of platelet-reactive antibody screening for patients facing frequent platelet transfusions

Tetsunori Tasaki, Kieko Fujii, Kenji Gotoh, Shyukuko Satoh, Jyunko Takadate, Sakiko Sasaki, Mihoko Tachibana, Kimiko Yamamoto

Immunohematology, Volume 18 , ISSUE 4, 104–108

Article | 09-November-2020

Semiautomation of platelet HPA-1a phenotyping by SPRCA and ELISA

An enzyme-linked immunosorbent assay (ELISA) and solid phase red cell adherence assay (SPRCA) were assessed for platelet HPA-1a typing in U well microplates. Both methods were partially automated by the use of the Tecan RSP 8051ID robotic sampler and the SLT 400 ATC plate reader with Soft2000 software. Pretreatment of the adherent platelets with chloroquine diphosphate or citric acid enabled anti-HPA-1a, even when contaminated with HLA class 1 antibodies, to be used for typing. Of 675 antenatal

Lionel A. Mohabir, Lynne Porter

Immunohematology, Volume 13 , ISSUE 2, 44–48

Article | 30-November-2020

Hemolytic transfusion reactions due to anti-e+f detectable only by nonstandard serologic techniques

. The patient’s RBCs typed as A, D+, probable Rh phenotype (cDE/cDE). The direct antiglobulin test was negative, and serum samples following the second transfusion were red/brown in color. Serologic investigations were inconclusive on all samples taken until February 13 (after the fourth transfusion). At this time, a weak anti-e reacting by manual polybrene technique and an anti-e+f reacting by two-stage papain technique were detected. The serum also contained potent HLA antibodies. The

Alan Devenish, Lesley A. Kay

Immunohematology, Volume 10 , ISSUE 4, 120–123

Case report | 14-October-2020

Neonatal alloimmune thrombocytopenia due to HPA-3a antibodies: a case report

A healthy infant was born at term by elective cesarean section to a 32-year-old para 4, gravida 4, mother. Within 24 hours, the infant was noted to have fairly extensive bruising on the back and shoulders. A full blood count evaluation was remarkable for severe thrombocytopenia (platelet count of 29 × 109 /L). Other hematologic parameters were normal. Human leukocyte antigen (HLA) class-1 antibodies but not platelet-specific antibodies were detectable in the maternal serum using a

A. Davoren, G. Smith, G. Lucas, S. Rodgers, P. O’Donoghue, J. Crowley, C.A. Barnes, J. McKiernan

Immunohematology, Volume 18 , ISSUE 2, 33–36

Article | 16-November-2020

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

The GLAM assay, a combined flow cytometric immunofluorescence test that simultaneously detects antibodies to granulocytes, lymphocytes, and monocytes, was used in the investigation of autoimmune neutropenia. This method avoids the need for a succession of immunofluorescence tests, first against granulocytes and then against lymphocytes, in order to distinguish granulocyte-specific from granulocyte/lymphocyte-reactive antibodies, such as noncomplement-fixing anti-HLA sera. Samples from 18

Anatole Lubenko, Sally Rosemary Wilson

Immunohematology, Volume 12 , ISSUE 4, 164–168

Article | 20-December-2020

Microcomputer-generated antigen panel worksheets

antigens or entire columns or rows of information. Once the worksheet template has been designed, it is automatically saved with the database file. More than one worksheet template can be stored in the database file. This program reduces the amount of time spent searching through records to find the necessary cells for testing. It also reduces potential error in hand copying antigen phenotypes to a worksheet. This application can also be used for HLA panels.

Rebecca R. Rose, Kathy J. Skradski, Margaret A. Helgeson, Herbert F. Polesky

Immunohematology, Volume 6 , ISSUE 2, 37–40

Review | 13-September-2016

Enthesopathies and enthesitis. Part 1. Etiopathogenesis

second part of the paper is a review of the state-of-the-art on the ability of imaging examinations to diagnose enthesitis. It indicates that none of the criteria of infl ammation used in imaging medicine is specifi c for this pathology. As enthesitis may be the only symptom of early spondyloarthropathy (particularly in patients with absent HLA-B27 receptor), the lack of its unambiguous picture in ultrasound and magnetic resonance scans prompts the search for other signs characteristic of this

Iwona Sudoł-Szopińska, Brygida Kwiatkowska, Monika Prochorec-Sobieszek, Włodzimierz Maśliński

Journal of Ultrasonography, Volume 15 , ISSUE 60, 72–84

Review | 13-September-2016

Enthesopathies and enthesitis. Part 2: Imaging studies

 only symptom of early spondyloarthritis (particularly in patients with absent HLA-B27 antigen), the lack of its unambiguous picture in ultrasound and magnetic resonance imaging prompts the search for other signs characteristic of spondyloarthritis and more specific features in imaging in order to make a diagnosis as early as possible.

Iwona Sudoł-Szopińska, Brygida Kwiatkowska, Monika Prochorec-Sobieszek, Grzegorz Pracoń, Marta Walentowska-Janowicz, Włodzimierz Maśliński

Journal of Ultrasonography, Volume 15 , ISSUE 61, 196–207

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