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Article | 09-November-2020

The use of polyethylene glycol (PEG) to enhance the adsorption of autoantibodies

The use of polyethylene glycol (PEG) to enhance the adsorption of warm autoantibodies on red blood cells (RBCs) was evaluated in our laboratory in an effort to reduce the time and cost associated with routine differential adsorptions. Sera from 19 patients with warm autoantibodies were tested. Fourteen of these sera contained alloantibodies or additional autoantibody specificities underlying the dominant autoantibody. The sera were differentially adsorbed using equal volumes of serum, reagent

Christina L. Barron, Mary Beth Brown

Immunohematology, Volume 13 , ISSUE 4, 119–122

Article | 16-October-2019

Use of the prewarm method for detecting clinically significant alloantibodies in the presence of cold autoantibodies

The prewarm (PW) method is useful for detecting and identifying clinically significant antibodies that bind to red blood cells and complement at 37°C and for avoiding antibodies that bind at temperatures less than 37°C. Antibodies that bind at temperatures less than 37°C are often cold autoantibodies that may be present in the serum of healthy individuals and are usually not clinically significant. The PW method is useful when these cold autoantibodies have a wide thermal range and

Stephanie Dupuis

Immunohematology, Volume 34 , ISSUE 4, 148–150

Case report | 14-December-2020

Case reports: red blood cell autoantibodies mimicking alloantibodies

The phenomenon of autoantibodies mimicking alloantibodies is rare and challenging. This report describes several unusual cases of mimicking autoantibodies and reviews the literature.

Ronald E. Domen, Ann Clarke

Immunohematology, Volume 7 , ISSUE 4, 98–101

Article | 28-April-2020

The incidence of red cell alloantibodies underlying panreactive warm autoantibodies

A recognized hazard of administering blood transfusions to patients with panreactive warm autoantibodies is that alloantibodies may be masked. Studies have shown the incidence of underlying alloantibodies to be 30 to 40 percent. Adsorption procedures can be used to remove autoantibodies and allow detection and identification of underlying alloantibodies. This study contains data from 126 patients referred to the Red Cell Immunohaematology laboratory at the National Blood Service, Newcastle upon

Martin Maley, David G. Bruce, Roderick G. Babb, Angus W. Wells, Mark Williams

Immunohematology, Volume 21 , ISSUE 3, 122–125

Report | 01-December-2019

Warm autoantibodies: time for a change

Routine adsorption procedures to remove autoantibodies from patients’ serum often require many hours to perform. This timeconsuming process can create significant delays that affect patient care. This study modified the current adsorption method to reduce total adsorption time to 1 hour. A ratio of one part serum to three parts red blood cells (RBCs; 1:3 method) was maintained for all samples. The one part serum was split into three tubes. Each of these three aliquots of serum was mixed

J. Ryan Nobles, Clare Wong

Immunohematology, Volume 29 , ISSUE 1, 5–10

Report | 14-March-2020

Allogeneic adsorptions: a comparison of the traditional method with a modified PEG adsorption method

The purpose of this study is to demonstrate the benefits of enhancing adsorptions with PEG. Allogeneic adsorptions were performed on 20 patient samples containing warm reactive autoantibodies with two volumes of adsorbing RBCs; results using unenhanced adsorptions were compared with those using PEG-enhanced adsorptions and with using untreated adsorbing RBCs and ficin-treated adsorbing RBCs. Two volumes of adsorbing RBCs, one volume of serum, and one volume of PEG were used. The number of

Mandy E. Etem, Barbara Laird-Fryer, Marie P. Holub, John J. Hedl, Daniel B. Symington, Dolores Figueroa

Immunohematology, Volume 26 , ISSUE 3, 104–108

Article | 10-November-2020

Autoimmune hemolytic anemia due to IgA class autoantibodies

that was thought to reflect the develop­ing autoimmune response. The autoantibodies had high affinity for red cells with very little free antibody detectable in the serum; in two instances Rh specificity was evident. Hemolysis was severe in four patients. Two of them had intravascular hemolysis, one of whom also had marked dyserythropoiesis and a transiently positive Ham’s test. Although IgA autoantibodies caused hemolysis pre­dominantly through immune adherence, on occasions they

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

Immunohematology, Volume 12 , ISSUE 1, 14–19

Article | 14-October-2020

PEG adsorption of autoantibodies causes loss of concomitant alloantibody

Use of polyethylene glycol (PEG) to promote adsorption of autoantibodies is reported to give good recovery of concomitant alloantibodies. In initial experiments, PEG and ZZAP (Ficin and DTT) adsorption procedures were compared for removal of autoantibody and recovery of alloantibody. Postadsorption studies (n = 11) were performed and hemagglutination scores compared. In subsequent studies, equal volumes of alloantibody containing sera, PEG, and antigen-negative red blood cells (RBCs) were used

W. John Judd, Louann Dake

Immunohematology, Volume 17 , ISSUE 3, 82–85

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 | 10-November-2020

Severe intravascular hemolysis due to autoantibodies stimulated by blood transfusion

Autoantibodies may cause severe hemolytic anemia, but only rarely are they the cause of a hemolytic transfusion reaction due to the destruction of transfused allogeneic blood. In two patients, autoantibody was detected shortly after blood transfusion. The first case was a D-negative patient who produced an autoanti-Ce and subsequently developed hemoglobinuria and hyperbilirubinemia. The second case was a patient who developed an autoanti-Wrb that caused severe hemolysis that resulted in death.

D. Chan, G.D. Poole, M. Binney, M.D. Hamon, J.A. Copplestone, A.G. Prentice

Immunohematology, Volume 12 , ISSUE 2, 80–83

Article | 17-November-2020

A simple screening method to evaluate the presence of alloantibodies with concomitant warm autoantibodies

Autoantibodies are present in the serum of patients with autoimmune hemolytic anemia. Extensive serologic investigation is often needed to determine if alloantibodies are also present. To aid in the investigation, a simple method of serum dilution is described. The serum dilution method was compared to allogeneic red blood cell adsorptions in 119 cases tested over a two-year period. In 20 percent of the cases, the same underlying alloantibodies were detected by both the serum dilution method

Ragnhild Øyen, Maria L. Angeles

Immunohematology, Volume 11 , ISSUE 3, 85–87

Article | 16-October-2019

Cold autoadsorption

Cold-reactive autoantibodies can mask the presence of underlying clinically significant alloantibodies in a patient’s plasma or serum. These autoantibodies are problematic when performing laboratory procedures such as ABO typing, red blood cell (RBC) crossmatching, antibody detection testing, and antibody identification. To avert the masking of clinically significant alloantibodies in a patient’s plasma or serum, adsorption studies can be performed at 4°C using autologous RBCs

Ernest M. Ekema

Immunohematology, Volume 34 , ISSUE 4, 158–160

Case report | 09-October-2019

Development of red blood cell autoantibodies following treatment with checkpoint inhibitors: a new class of anti-neoplastic, immunotherapeutic agents associated with immune dysregulation

chart review, including serologic, hematology, and chemistry laboratory results, of two patients who developed red blood cell (RBC) autoantibodies during treatment with a checkpoint inhibitor. Serologic testing of blood samples from these patients during induction therapy with ipilimumab and nivolumab, respectively, showed their RBCs to be positive by the direct antiglobulin test (IgG+, C3+) and their plasma to contain panreactive RBC autoantibodies. Neither patient had evidence of hemolysis. Both

Laura L.W. Cooling, John Sherbeck, Jonathon C. Mowers, Sheri L. Hugan

Immunohematology, Volume 33 , ISSUE 1, 15–21

Article | 16-October-2019

Warm autoadsorption using ZZAP

The masking of clinically significant alloantibodies by warm autoantibodies presents challenges in pretransfusion testing. The adoption of transfusion practices such as the issuing of “least incompatible” red blood cells (RBCs) without a complete antibody workup is potentially unsafe for patients. Several autoadsorption methods can be used to remove autoantibody reactivity. ZZAP treatment of autologous RBCs is an efficient way to prepare the cells for autoadsorption. Autoadsorbed

Farai M. Tsimba-Chitsva, Amy Caballero, Becky Svatora

Immunohematology, Volume 34 , ISSUE 1, 1–3

Article | 15-April-2020

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

method. There are a limited number of direct agglutinating monoclonal antibodies available. Murine monoclonal antibodies provide an additional tool for typing RBCs with a positive DAT. Five murine monoclonal IgG antibodies (anti-K: MIMA-22, MIMA-23; anti-Kpa: MIMA-21, MIMA-27; anti-Fya: MIMA-19) were used in this study. Donor RBCs with known phenotypes were sensitized in vitro with alloanti-D, alloanti-c, and alloanti-K and with 20 autoantibodies (autoanti-D [n=3],autoanti-e [n=5], autoanti-Ce/e [n=5

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

Immunohematology, Volume 22 , ISSUE 4, 161–165

Review | 01-December-2019

Thermal amplitude test

The thermal amplitude test is performed to determine the reactivity of a cold autoantibody at varying temperatures: 4°C, 22°C, 30°C, and 37°C. Cold autoantibodies that are reactive at temperatures greater than 30°C have the potential to be clinically significant regardless of the antibody titer. Cold autoantibodies that are reactive at temperatures less than 30°C are not considered to be clinically significant.

Courtney Hopkins, Tiffany K. Walters

Immunohematology, Volume 29 , ISSUE 2, 49–50

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

Article | 26-October-2020

Specificity of autoantibodies reacting optimally at 37°C

George Garratty

Immunohematology, Volume 15 , ISSUE 1, 24–40

Report | 26-October-2019

Clinical and reference lab characteristics of patients with suspected direct antiglobulin test (DAT)-negative immune hemolytic anemia

Matthew S. Karafin, Gregory A. Denomme, Michael Schanen, Jerome L. Gottschall

Immunohematology, Volume 31 , ISSUE 3, 108–115

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 | 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

Case report | 29-October-2019

Evans syndrome in a pediatric liver transplant recipient with an autoantibody with apparent specificity for the KEL4 (Kpb) antigen  

Although most warm red blood cell (RBC) autoantibodies react broadly with panel cells in addition to the patient’s own RBCs, occasionally an autoantibody with specificity for a specific blood group antigen is encountered. Rare cases of warm autoantibodies with specificity for the Kpb antigen of the Kell blood group system have been described. We report a pediatric transplant recipient with anemia, immune-mediated hemolysis, thrombocytopenia, and a warm autoantibody with apparent anti-Kpb

Scott A. Koepsell, Kerry Burright-Hittner, James D. Landmark

Immunohematology, Volume 30 , ISSUE 1, 14–17

Review | 01-December-2019

Cold acid elution (ELU Kit II)

antibody recovery in most cases, such as recovery of alloantibodies and warm-reactive autoantibodies. Studies have compared methods such as xylene, chloroform, digitonin acid, dichloromethane, citric acid, and Immucor Elu-Kit II (cold acid elution). The ELU-Kit II has been shown to be quick and effective at eluting a wide range of alloantibodies as well as autoantibodies without the use of hazardous chemicals or costly reagent preparation time that some methods use. It is for these reasons that the ELU

Monica Hinrichs, Monica A. Keith

Immunohematology, Volume 30 , ISSUE 3, 113–116

Report | 14-March-2020

The significance of a positive DAT in thalassemia patients

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

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

with a negative DAT. For healthy blood donors, mean values were 58 IgG, 16 IgA, and 3 IgM molecules per RBC. For patients with a positive DAT, the mean values were 3435 IgG, 157 IgA, and 69 IgM molecules per RBC. An increased level of IgA was found in 12 patients without IgA autoantibodies demonstrable in RBC eluates. Increased IgG levels were also observed in patients with a negative DAT and, in one case, an increased level of IgA was also found. The enzyme-linked immunosorbent assay using ether

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

Immunohematology, Volume 19 , ISSUE 2, 47–53

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 | 20-December-2020

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

Teresa Y. Harris

Immunohematology, Volume 6 , ISSUE 4, 87–91

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

Report | 12-March-2020

Determination of optimal method for antibody identification in a reference laboratory

-phase methods. Of the 254 samples tested, 115 showed agreement in antibody identification with all three methods. The tube method identified all but six clinically significant antibodies. The gel method did not identify 59 clinically significant antibodies. Fifty-six clinically significant antibodies were not identified by solid-phase testing. Tube testing identified 27 clinically insignificant antibodies, primarily cold autoantibodies. Gel and solid-phase methodologies identified two and three cold

Jennifer R. Haywood, Marilyn K. Grandstaff Moulds, Barbara J. Bryant

Immunohematology, Volume 27 , ISSUE 4, 146–150

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

Review | 16-October-2019

A brief overview of clinical significance of blood group antibodies

Manish J. Gandhi, D. Michael Strong, Barbee I. Whitaker, Evangelia Petrisli

Immunohematology, Volume 34 , ISSUE 1, 4–6

Article | 22-January-2021

A case of megaloblastic anemia simulating a cold autoimmune hemolytic anemia

. Anti-I specificity was identified by testing the patient’s serum against adult OI RBCs, OI RBCs treated with ficin, Oi cord RBCs, autologous RBCs, and group O RBCs. Cold autoantibodies reacted more strongly with OI adult RBCs than with Oi cord RBCs. Anti-I titer was less than 64 at 4°C. Serum protein electrophoresis and immunoglobulin levels (IgM/IgG/IgA) were normal. T-receptor cell analysis of bone marrow (BM) was polyclonal. Lymphocyte immunophenotype assessed by flow cytometry was normal. Total

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

Immunohematology, Volume 36 , ISSUE 3, 89–92

Case report | 01-December-2019

A case of masquerading alloantibodies:  the value of a multitechnique approach

Paula M.S. Wennersten, Laurie J. Sutor

Immunohematology, Volume 30 , ISSUE 3, 117–120

Case report | 16-March-2020

Autoantibody formation after alloimmunization inducing bystander immune hemolysis

The development of RBC autoantibodies resulting from or associated with allogeneic blood transfusions is not an easily determined complication of RBC transfusions. This report discusses one patient who developed RBC autoantibodies in association with an allogeneic blood transfusion and alloimmunization leading to a temporary bystander immune hemolysis. A 72-year-old woman was hospitalized as a result of severe anemia and received two units of ABO- and D-compatible RBCs. She had a history of two

Mariza Mota, C. Bley, M.G. Aravechia, N. Hamerschlak, A. Sakashita, J.M. Kutner, L. Castilho

Immunohematology, Volume 25 , ISSUE 1, 9–12

Review | 01-December-2019

Allogeneic red blood cell adsorption for removal of warm autoantibody

. Adsorption may also be performed using enhancement such as low-ionic strength saline or polyethylene glycol added to the mixture. Multiple adsorptions may be necessary to remove strongly reactive autoantibodies. Allogeneic adsorptions will not detect alloantibodies to high-prevalence antigens.

Christina Barron

Immunohematology, Volume 30 , ISSUE 4, 153–155

Article | 15-February-2021

Albumin-indirect antiglobulin test

method used in antibody identification studies. The increased tendency for 37°C agglutination when using albumin may allow recognition of antibody specificity before the AHG phase. This step is especially helpful when multiple alloantibodies are present; Rh system antibodies are most likely to react at this test phase. Newly developing antibodies may show increased reactivity in 37°C tests when compared with AHG tests using anti-IgG. Conversely, warm autoantibodies generally have decreased reactivity

J.R. Hamilton

Immunohematology, Volume 35 , ISSUE 2, 63–64

Review | 12-March-2020

Granulocyte serology: current concepts and clinical signifcance

Applying serologic procedures to the detection of RBC and lymphocyte antigens has facilitated the identification of granulocyte antigens with established clinical significance, which are now classified in the human neutrophil antigen system. Granulocyte alloantibodies and autoantibodies have been implicated in a variety of clinical conditions including alloimmune neutropenia, autoimmune neutropenia, febrile and severe pulmonary transfusion reactions, drug-induced neutropenia, refractoriness to

Mary E. Clay, Randy M. Schuller, Gary J. Bachowski

Immunohematology, Volume 26 , ISSUE 1, 11–21

Review | 26-July-2017

Immune dysfunction and neuroinflammation in autism spectrum disorder

, monocytes, natural killer cells, and dendritic cells. Also, many individuals diagnosed with ASD have alterations in immunoglobulins and increased autoantibodies. Finally, a significant portion of individuals diagnosed with ASD have elevated peripheral cytokines and chemokines and associated neuroinflammation. In conclusion, immune dysregulation and inflammation are important components in the diagnosis and treatment of ASD.

Geir Bjørklund, Khaled Saad, Salvatore Chirumbolo, Janet K. Kern, David A. Geier, Mark R. Geier, Mauricio A. Urbina

Acta Neurobiologiae Experimentalis, Volume 76 , ISSUE 4, 257–268

Article | 16-February-2021

Saline–indirect antiglobulin test

. Procedural steps captured from Fung.4 RBC = red blood cell; PBS = phosphate-buffered saline; IAT = indirect antiglobulin test. Indications Saline testing is a method used in antibody detection and identification studies. The saline-IAT is rarely used as a primary RBC antibody detection method. Rather, the usefulness of saline testing lies in the flexibility of the tests that can be performed. Applications of saline tests include: Confirmation of cold-reacting allo- or autoantibodies in saline

J.R. Hamilton

Immunohematology, Volume 35 , ISSUE 4, 156–158

Review | 15-May-2020

Review: immune thrombocytopenic purpura: an update for immunohematologists

Immune thrombocytopenic purpura (ITP) is an acquired disease in which autoantibodies to platelets cause their sequestration and destruction by mononuclear macrophages, principally in the spleen. If increased production of platelets by megakaryocytes does not compensate for platelet destruction, the number of circulating platelets decreases (thrombocytopenia), resulting in a characteristic bleeding tendency (purpura). While most children with the disease experience a relatively short and benign

S. Gerald Sandler

Immunohematology, Volume 20 , ISSUE 2, 112–117

Report | 06-November-2019

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

Drug-induced immune hemolytic anemia (DIIHA) is a rare condition that occurs primarily as a result of drug-induced antibodies, either drug-dependent or drug-independent. Drugdependent antibodies can be detected by testing drug-treated red blood cells (RBCs) or untreated RBCs in the presence of a solution of drug. Drug-independent antibodies react with untreated RBCs (no drug added) and cannot be distinguished from warm autoantibodies.  Many changes have occurred during the last 30 years

Patricia A. Arndt

Immunohematology, Volume 30 , ISSUE 2, 44–54

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

Report | 06-November-2019

How we investigate drug-induced immune hemolytic anemia

antibodies are investigated by testing drug-treated red blood cells (RBCs) or by testing RBCs in the presence of a solution of drug. Drug-independent antibodies are serologically indistinct from idiopathic warm autoantibodies and cannot be defined or excluded by serologic testing. Nonimmunologic protein adsorption, caused by some drugs, is independent of antibody production but may also cause immune hemolytic anemia. Serologic methods for testing for drug antibodies are presented, and observations from

Regina M. Leger, Patricia A. Arndt, George Garratty

Immunohematology, Volume 30 , ISSUE 2, 85–94

Case report | 06-November-2019

Diagnostic pitfalls of drug-induced immune hemolytic anemia

Abdulgabar Salama, Beate Mayer

Immunohematology, Volume 30 , ISSUE 2, 80–84

Case report | 13-September-2016

The value of ultrasound in the diagnosis of limited scleroderma – a case report

Systemic sclerosis, popularly referred to as scleroderma, is a chronic connective tissue disease with present autoantibodies against platelet-derived growth factor receptor. These antibodies activate directly fi broblasts causing the dermis and internal organs’ fi brosis and vascular damage. Additionally, calcifi c collections, including hydroxyapatite crystals, may develop in subcutaneous tissue and juxta-articular soft tissue. Herein, we report a case of a 72-year-old woman, referred by a

Grzegorz Pracoń, Mateusz Płaza, Marta Walentowska-Janowicz, Iwona Sudoł-Szopińska

Journal of Ultrasonography, Volume 15 , ISSUE 62, 326–331

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 | 03-November-2020

Paroxysmal cold hemoglobinuria and the elusive DonathLandsteiner antibody

following a rapid drop in hemoglobin of 30 g/L; the DAT was positive with anti-C3d. A 17-month-old female, unwell for 2 weeks, had a hemoglobin of 41 g/L; the DAT was strongly positive with anti-C3d and weakly positive with anti-IgG and -C3c. In all patients, PCH was confirmed by positive indirect DonathLandsteiner tests, and the autoantibodies demonstrated P specificity. In two patients, the test was strongly positive; in the third patient, it was only positive using papainized red cells; and in the

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

Immunohematology, Volume 14 , ISSUE 3, 109–112

Article | 03-November-2020

Comparison of affinity column technology and LISS tube tests

column technology and by LISS tube technique. Both methods detected antibodies directed at common RBC antigens, high-incidence and low-incidence RBC antigens, and warm-reacting autoantibodies. IgM antibodies were not detected by affinity column technology. Affinity column technology compares favorably with the LISS tube technique for IgG antibody detection and identification.

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

Immunohematology, Volume 14 , ISSUE 4, 149–151

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

from RBCs. Acid eluates from 51 peripheral blood (PB) and 7 cord blood (CB) samples were evaluated by both an automated SPRCA instrument and a manual GMC assay. The concordance rate between the two systems for peripheral RBC samples was 88.2 percent (45 of 51), including cases with alloantibodies (n = 8), warm autoantibodies (n = 12), antibodies with no identifiable specificity (n = 2), and negative results (n = 23). There were six discordant cases, of which four had alloantibodies (including anti

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

Report | 25-March-2020

The potential of blood group genotyping for transfusion medicine practice

, electronic selection of units antigen-matched at multiple blood group loci is then possible.  This paper discusses the potential of this approach to improve transfusion therapy by reducing or eliminating alloantibody production in specific patient populations.  These include patients facing long-term transfusion therapy and at high risk for sensitization; patients with warm autoantibodies when compatibility cannot be demonstrated by standard methods; and women for whom the production of

Connie M. Westhoff

Immunohematology, Volume 24 , ISSUE 4, 190–195

Article | 17-February-2021

A prospective, observational study for optimization of antibody screening in pretransfusion compatibility testing

in these studies demonstrated any clinical or serologic evidence of hemolysis.4–7 The safety of this approach was further evaluated in massive transfusion and also in patients with autoantibodies.8–13 The Indian literature has some data in which transfusion safety with the use of TS and IST crossmatch has been compared with AHG crossmatch.14–18 These studies have revealed that the TS approach is safe and cost-effective. Despite knowing the use of AS, it has not been uniformly adopted as a part of

P. Pandey, D. Setya, R. Srivastava, M.K. Singh

Immunohematology, Volume 36 , ISSUE 1, 19–28

Article | 26-October-2019

Multiplex ligation-dependent probe amplification assay for blood group genotyping, copy number quantification, and analysis of  RH variants

extensive analysis of RHD variants. In our reference lab in the Netherlands, the MLPA was validated to detect RH variants in patients, donors, and pregnant women. Furthermore, we have used the MLPA to provide comprehensive typing after blood transfusion of 52 blood group antigens simultaneously, in patients with red cell autoantibodies or patients with rare phenotypes.

Barbera Veldhuisen, C. Ellen van der Schoot, Masja de Haas

Immunohematology, Volume 31 , ISSUE 2, 58–61

Report | 06-November-2019

Drug-induced immune thrombocytopenia: incidence, clinical features, laboratory testing, and pathogenic mechanisms

proposal suggests weakly reactive platelet autoantibodies that develop greatly increased affinity for platelet glycoprotein epitopes through bridging interactions facilitated by the drug is a possible mechanism for the formation and reactivity of quinine-type drug antibodies.

Brian R. Curtis

Immunohematology, Volume 30 , ISSUE 2, 55–65

Article | 17-February-2021

Clinical impacts of DNA-based typing and provision of antigen-matched red blood cell units for chronically transfused patients with thalassemia

is inaccurate because of the contaminating donor erythrocytes in patient circulation. DNA-based typing is superior in situations of recent transfusions.8 Moreover, it can guide the antigen-matched transfusion in individual patients. Furthermore, autoantibodies are frequently found in patients with thalassemia, causing crossmatch problems.9 The prevalence of autoantibodies is 0.47–28.2 percent by direct antiglobulin test and 57.6 percent by flow cytometry depending on study population and

P. Watanaboonyongcharoen, S. Onspun, P. Rojnuckarin

Immunohematology, Volume 36 , ISSUE 4, 137–145

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