Report | 01-December-2019
Transfusing uncrossmatched red blood cells (RBCs) can be a lifesaving bridge until crossmatched RBCs are available. The risk of using uncrossmatched RBCs is that of hemolysis from unexpected clinically significant antibodies. This study sought to quantify the risk of hemolysis after the transfusion of uncrossmatched RBCs. The records of recipients of uncrossmatched RBCs over approximately 9 months were retrieved from the regional transfusion service. Basic immunohematologic data were recorded
Lisa Radkay,
Darrell J. Triulzi,
Mark H. Yazer
Immunohematology, Volume 28 , ISSUE 2, 39–44
Case report | 16-March-2020
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
Report | 29-October-2019
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
Case report | 16-March-2020
Passenger lymphocyte syndrome (PLS) is a well-recognized complication that may follow a hematopoietic progenitor cell or solid-organ transplant. Typically, the syndrome presents as acute hemolysis of the recipient’s RBCs, which have become serologically incompatible with blood group antibodies formed by passively transfused donor-origin B lymphocytes. Most cases involve anti-A or anti-B. However, there are cases involving non-ABO serologic incompatibility, as well as cases in which the
Addisalem T. Makuria,
Albert Langeberg,
Thomas M. Fishbein,
S. Gerald Sandler
Immunohematology, Volume 25 , ISSUE 1, 20–23
Case report | 06-December-2020
We present the differential diagnosis for a Coombs-positive immune hemolysis having onset during hospitalization and, in particular, during the postoperative period. The stimulus for this article was a delayed hemolytic transfusion reaction (DHTR) due to anti-U following open-heart surgery. The initial clinical and serologic findings led us to consider other causes of immune hemolysis which are reviewed in this article. To our knowledge, this is the fourth case of a DHTR due to anti-U to be
Gnanasagren Sathaseevan Pillay,
Betty Womack,
S. Gerald Sandler
Immunohematology, Volume 9 , ISSUE 2, 41–46
Article | 14-October-2020
in 179 (38.7%) cases. The incidence of a positive DAT was higher in the group of patients with > 2 signs of hemolysis (4/34 cases; 11.8%) than in the group of patients with ≤ 2 signs of hemolysis (5/145 cases;3.4%) (RR = 0.029;95% CI:0.08–1.03;p = 0.06). When a patient with anemia is being investigated, a complete laboratory evaluation for suspected hemolytic anemia should be done before performing a DAT.
Joan Cid,
Xavier Ortín,
Víctor Beltran,
Lourdes Escoda,
Enric Contreras,
Enric Elies,
Carmen Martín-Vega
Immunohematology, Volume 19 , ISSUE 1, 16–18
Article | 10-November-2020
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
Intravascular hemolysis due to passive transfer of anti-A or anti-B has been a frequently reported transfusion complication. In most reported cases, passive anti-A has been implicated. However, cases of hemolysis due to anti-B have also been reported following administration of intravenous immunoglobulin (IVIG) and during platelet transfusions. In our case, a 6-day-old infant with E. coli sepsis underwent double-volume exchange transfusion for hyperbilirubinemia. Modified whole blood used
Gregg Boothe,
Mark E. Brecher,
Mamie B. Root,
Judy Robinson,
Nancy R. Haley
Immunohematology, Volume 11 , ISSUE 2, 43–45
Article | 09-November-2020
fetal red blood cells of her one pregnancy (the recipient). The kidney had been immediately perfused with saline after removal from the donor. No acute or delayed hemolysis was observed clinically or in laboratory tests performed immediately after the transplant and at 7, 15, and 30 days after the transplant. Antibody screens were still negative at 6 months. In this case, anti-E was not present in the transplanted kidney in sufficient concentration to cause hemolysis of the recipient’s red
Marcia C. Zago-Novaretti,
Carlos Roberto Jorge,
Eduardo Jens,
Pedro Enrique Dorihiac-Llacer,
Dalton de Alencar Fischer Chamone
Immunohematology, Volume 13 , ISSUE 4, 138–140
Article | 17-February-2021
and Ge3, and those in the Kell, Cartwright, Indian, JMH, Scianna, LW, Lutheran, Dombrock, Diego, and Cromer blood group systems—of which the most important is K.7 A common practice in these patients, therefore, is to transfuse K– RBC units unless the patients have been typed as K+.
DTT treatment of RBCs has the potential to cause hemolysis at certain concentrations which can interfere with interpretation of results.8–12 Standard DTT treatment of RBCs is performed with 0.2 M DTT, although at this
P. Pandey,
D. Setya,
E. Kaul,
S. Ranjan,
M.K. Singh,
A. Shankar
Immunohematology, Volume 36 , ISSUE 4, 157–165
Case report | 11-March-2020
intravascular hemolysis, including hemoglobinuria. Testing revealed a complement-dependent anti-AnWj. Phenotyping confirmed the AnWj– phenotype. Anti-AnWj was persistent despite immunosuppression, including treatment with allogeneic HSCT. Of interest, the pathogenesis of the downregulation of the graft AnWj in this patient is unclear.
George Grigoriadis,
Jennifer Condon,
Kate Green,
Mary Ann Anderson,
Marija Borosak,
Erica Wood
Immunohematology, Volume 27 , ISSUE 3, 83–88
Article | 06-December-2020
A group A, D-positive patient underwent orthotopic liver transplantation from a group A, D-negative (cde/cde) donor. Anti-D and -E were eluted from the recipient’s red cells and were found in the recipient’s serum 13 days later, at which time significant hemolysis developed. These Rh antibodies appear to he secondary to passive transfer of sensitized donor lymphocytes, a rare finding following liver transplantation.
Brian K. Kim,
Carolyn F. Whitset,
Christopher D. Hillyer
Immunohematology, Volume 8 , ISSUE 4, 100–101
Review | 26-October-2019
glycosylphosphatidylinositol (GPI) anchor. A defect of this anchor causes lack of this protein from the cell membrane, which leads to an enhanced sensitivity towards complement attack. Patients with paroxysmal nocturnal hemoglobinuria (PNH) harbor a varying percentage of red blood cell clones with a defect in GPI-anchored proteins, including CD59. The most characteristic symptoms of this disease are episodes of hemolysis and thromboses. Although CD59 has been classified as a membrane protein for more than 25 years, an
Christof Weinstock,
Markus Anliker,
Inge von Zabern
Immunohematology, Volume 31 , ISSUE 4, 145–151
Review | 28-April-2020
Karina Yazdanbakhsh
Immunohematology, Volume 21 , ISSUE 3, 109–118
Article | 21-April-2020
Auto anti-N is infrequently encountered and, in most reported cases,does not cause clinical hemolysis. This case reports an auto anti-N associated with severe hemolytic anemia (Hb = 2.7 g/dL) in a 6-year-old Caucasian girl with a history of vomiting, fever, and abdominal pain. Upon admission, she was found to have a metabolic acidosis,secondary to her severe anemia,with abnormal liver function tests. As in three other case reports,the autoimmune hemolytic anemia resolved,with disappearance of
Caroline C. Immel,
Myra McPherson,
Shauna N. Hay,
Linda R. Braddy,
Mark E. Brecher
Immunohematology, Volume 21 , ISSUE 2, 63–65
Report | 01-December-2019
. After deglycerolization, RBCs were preserved with either SAG-M or AS3 and stored for at least 10 or 14 days, respectively. Quality of stored RBCs was assessed by measuring osmolarity, blood cell counts, free hemoglobin, adenosine triphosphate (ATP), hemolysis, and glucose. The overall RBC mass recovery after deglycerolization was 86 ± 7.6 percent, and the osmolarity was 336 ± 23 mOsml/kg H2O. The hemolysis for stored components at the end of their shelf life was 0.21 ± 0.08
Jana List,
Michaela Horvath,
Gerda C. Leitner,
Günter Weigel
Immunohematology, Volume 28 , ISSUE 2, 67–73
Article | 21-April-2020
was red. Her Hb dropped from 8.4 to 6.4 g/dL over 24 hours after the transfusion. Her total bilirubin rose to 4.0 mg/dL, with an LDH value of 1558 U/L and a haptoglobin of 10.9 mg/dL. Both the antibody detection test and the DAT were positive. An anti-Fy3 was identified in the serum and in the eluate. To the best of our knowledge,this is the first case of acute intravascular hemolysis due to anti-Fy3 in a patient without sickle cell disease.
Horatiu Olteanu,
David Gerber,
Kara Partridge,
Ravindra Sarode
Immunohematology, Volume 21 , ISSUE 2, 48–52
Review | 16-May-2020
Lawrence D. Petz
Immunohematology, Volume 20 , ISSUE 3, 167–176
Article | 18-October-2020
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 | 06-December-2020
Immune hemolytic anemia due to minor ABO incompatibility between recipient and donor is a well-recognized occurrence in kidney and liver transplantation. In some cases, the responsible antibodies have been shown to be derived from the donor passenger lymphocytes using Gm allotyping. We report a case of acute, transient hemolysis following heart-lung transplantation in which serologic and Gm allotype studies confirmed the etiology of hemolysis.
EIizabeth J. Perlman,
Rosetta S. Shirey,
Mary Farkosh,
Thomas S. Kickler,
Paul M. Ness
Immunohematology, Volume 8 , ISSUE 2, 38–40
Report | 09-October-2019
14 days for observation of hemolysis. In Set 1, all antigen reactivity remained at ≥2+ with both single- and double-dose cells for 14 days. The Rh antigens gave stronger reactions longer, compared with those tested in the Duffy, Kidd, and MNS blood group systems. Sets 2 and 3 were monitored for hemolysis. On day 3, Set 2 began displaying hemolysis, with complete hemolysis by day 8. Set 3 did not display hemolysis in 14 days. In conclusion, a large volume of RBCs can be treated with DTT and
Wendy L. Disbro
Immunohematology, Volume 33 , ISSUE 3, 105–109
Case report | 06-December-2020
Tolmetin, a nonsteroidal anti-inflammatory drug, was found to be the etiologic agent in a case of drug-induced hemolytic anemia. A 35-year-old female who had ingested tolmetin sporadically in the past took two doses that resulted in acute hemolysis. Two days after taking the second dose, she had a hemoglobin of 7.0 g/dL, increased serum lactate dehydrogenase, reticulocytosis, and indirect reacting hyperbilirubinemia. The direct antiglobulin test was weakly positive with anti-lgG and
LeeAnn McCall,
Michael R. Owens
Immunohematology, Volume 8 , ISSUE 1, 17–18
Article | 01-April-2020
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
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
Case report | 29-October-2019
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
Case report | 06-November-2019
Abdulgabar Salama,
Beate Mayer
Immunohematology, Volume 30 , ISSUE 2, 80–84
Case report | 01-December-2019
Although antibodies to antigens in the Rh blood group system are common causes of warm autoimmune hemolytic anemia, specificity for only the D antigen is rare in autoimmune hemolysis in pediatric patients. This case reports an anti-D associated with severe hemolytic anemia (Hb = 2.1 g/dL) in a previously healthy 14-month-old child who presented with a 3-day history of low-grade fevers and vomiting. Because of his severe anemia, on admission to the hospital he was found to have altered mental
Rachel S. Bercovitz,
Margaret Macy,
Daniel R. Ambruso
Immunohematology, Volume 29 , ISSUE 1, 15–18
Case report | 27-April-2020
,she did not develop laboratory or clinical evidence of acute hemolysis. The patient’s anti-Jra had a pretransfusion titer of 4 and a monocyte monolayer assay (MMA) reactivity of 68.5% (reactivity > 5% is considered capable of shortening the survival of incompatible RBCs). The titer increased fourfold to 64 and the MMA reactivity was 72.5% on Day 10 posttransfusion. Review of laboratory data showed evidence of a mild delayed hemolytic transfusion reaction by Day 10 posttransfusion. Despite
Shan Yuan,
Rosalind Armour,
Allison Reid,
Khaled F. Abdel-Rahman,
Michael Phillips,
Dawn M. Rumsey,
Theresa Nester
Immunohematology, Volume 21 , ISSUE 3, 97–101
Article | 03-November-2020
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 findings of immune-mediated hemolytic anemia (autoimmune hemolytic anemia and cold agglutinin disease) are not infrequent in patients with sickle cell disease and can be clinically significant. Features of sickle cell disease that may affect the emergence and intensity of immune-mediated hemolysis include the antigenic stimulation of chronic red blood cell (RBC) transfusions, increased autoantibody production, RBC membrane defects, and functional asplenism. We describe two patients
Raymond L. Comenzo,
Marie E. Malachowski,
Eugene M. Berkman
Immunohematology, Volume 8 , ISSUE 1, 13–16
Report | 06-November-2019
Drugs are a rare cause of immune hemolytic anemia, but an investigation for a drug antibody may be warranted if a patient has definitive evidence of immune hemolysis, other more common causes of hemolysis have been excluded, and there is a good temporal relationship between the administration of a drug and the hemolytic event. Drug antibodies are either drug-dependent (require drug to be in the test system) or drug-independent (reactive without drug present in the test). Drug-dependent
Regina M. Leger,
Patricia A. Arndt,
George Garratty
Immunohematology, Volume 30 , ISSUE 2, 85–94
research-article | 23-September-2021
Magdalena Godkowicz,
Karolina Rudnicka
Advancements of Microbiology – Postepy Mikrobiologii, Volume 60 , ISSUE 3, 211–222
Article | 30-November-2020
Walter H. Dzik,
Joyce Blank,
Paula Lutz,
Thomas G. Hirose,
Christine Lomas-Francis,
Marilyn Moulds
Immunohematology, Volume 10 , ISSUE 4, 117–119
Case report | 24-March-2020
Wra is a low-prevalence antigen. Anti-Wra is a relatively common antibody present in approximately 1 in 100 healthy blood donors. Anti-Wra is reported to cause different degrees of hemolysis in transfusion and in HDN, ranging from benign to severe. This report describes an acute overt hemolytic transfusion reaction in a patient whose serum contained anti-Wra and who received a Wr(a+) RBC component.
Fouad N. Boctor
Immunohematology, Volume 24 , ISSUE 3, 113–115
Article | 09-November-2020
Complement has a complex role in immune mediated red blood cell (RBC) destruction and usually induces extravascular hemolysis of C3bcoated RBCs by erythrophagocytosis and by acting synergistically with cell-bound immunoglobulins. A sensitive two-stage enzyme-linked direct antiglobulin test (ELDAT) was developed and used to measure RBC-bound C3b and C3d in 120 healthy adult individuals and in 60 patients suffering from a variety of conditions, including warm- and cold-type autoimmune hemolytic
J.D. Bellamy,
D.J. Booker,
N.T. James,
R. Stamps,
R.J. Sokol
Immunohematology, Volume 13 , ISSUE 4, 123–131
Article | 09-November-2020
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 | 03-November-2020
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 | 15-February-2021
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 | 09-November-2020
A 37-year-old male presented with severe anemia, mild jaundice, and hemoglobinuria during his second course of diclofenac for gout. The peripheral blood showed microspherocytes and nucleated red blood cells (RBCs). The reticulocyte count was 21 percent and haptoglobin was < 0.1 g/L. A presumptive diagnosis of diclofenac-induced immune hemolysis was made and blood, urine, and drug samples were referred for investigation. Direct antiglobulin testing showed the RBCs to be coated with IgG1, IgG4
S.T. Laidlaw,
R. Stamps,
D.J. Booker,
M.J. Brown,
R.J. Sokol
Immunohematology, Volume 13 , ISSUE 1, 9–11
Case report | 06-December-2020
A child with a history of recent viral infection entered the hospital with severe anemia, hemoglobinuria, and suspected autoimmune disease. Serologic findings included a positive direct antiglobulin test and incompatible crossmatches. Extensive studies, including a Donath-Landsteiner test, confirmed paroxysmal cold hemoglobinuria. The child was transfused several times with washed red blood cells compatible by prewarm technique. Although hemolysis continued after each transfusion, he stabilized
Carol A. Putnam
Immunohematology, Volume 8 , ISSUE 1, 19–21
Review | 01-December-2019
The Cartwright (Yt) blood group system consists of two antigens, Yta and Ytb, that result from point mutations in the acetylcholinesterase gene on chromosome 7q. Yta is a highincidence antigen, whereas its antithetical antigen, Ytb, shows much lower incidence. Anti-Yta and anti-Ytb are relatively rare. Anti-Yta is more commonly found in individuals of Jewish descent. Cartwright antibodies are rarely clinically significant; however, cases of in vivo hemolysis have been reported, suggesting that
Melissa R. George
Immunohematology, Volume 28 , ISSUE 2, 49–54
Article | 16-May-2020
A 24-year old female,gravida III,para III,delivered a full-term infant by cesarean section. A maternal blood sample at the time of admission showed antibody in her serum that had apparent anti-e specificity and that her RBCs were e+. Further studies determined that the antibody was anti-hrS. Cord RBCs had a negative DAT and a normal Hb level. There was no clinical evidence for increased hemolysis in the infant. We describe an hrS+ infant with no evidence of HDN due to anti-hrS.
Ram Kakaiya,
Jill Cseri,
Beth Jochum,
Laurie Gillard,
Simone Silberman
Immunohematology, Volume 20 , ISSUE 3, 187–189
Letter to Editor | 06-December-2020
Valerie Jackson,
Aaron M. Josephson,
Jill Storry,
Debra Futral,
Floyd T. Boudreau
Immunohematology, Volume 8 , ISSUE 3, 79–79
Article | 30-November-2020
the reactivity at the IAT. The patient was transfused with two units of washed RBCs and died 6 to 8 hours later. Retrospective testing in our laboratory detected anti-Vel in both pretransfusion and posttransfusion samples. The pretransfusion serum was hemolytic when tested in LISS or with papain-treated RBCs. Weak reactivity (1+) was observed at the IAT. EDTA-treated serum (to prevent C‘-mediated hemolysis) was strongly reactive (3+s) with Vel+ RBCs but compatible with 10 examples of Vel
Jill Storry,
Delores Mallory
Immunohematology, Volume 10 , ISSUE 3, 83–86
Article | 02-May-2020
treatment with two units of PRBCs and experienced gradual resolution of hemolysis. Our case emphasizes the need for increased awareness of delayed onset hemolytic anemia following prophylactic use of cefotetan.
Sherry Shariatmadar,
Jill R. Storry,
Laima Sausais,
Marion E. Reid
Immunohematology, Volume 20 , ISSUE 1, 63–66
Case report | 01-December-2019
dehydrogenase, and urine hemoglobin were within normal limits. A monocyte monolayer assay performed on this anti-Ge2 supports the data that antibodies of this specificity do not cause hemolysis. The clinical and laboratory data obtained in our patient clearly indicated that no hemolysis of transfused RBCs occurred during and for 24 hours after transfusion. We believe that this report adds to a limited experience with antiGe2 and provides further evidence for concluding that, in all likelihood, this is not a
Deepthi Karunasiri,
Frederick Lowder,
Nora Ostrzega,
Dennis Goldfinger
Immunohematology, Volume 30 , ISSUE 4, 156–157
Report | 26-October-2019
Clinical evidence of warm autoimmune hemolytic anemia is present in 1 percent to 10 percent of patients whose direct antiglobulin test (DAT) is negative. The clinical underpinnings associated with DAT-negative immune hemolysis are poorly understood, and the current study aimed to further define the clinical characteristics associated with this form of anemia. A 19-question survey, requesting clinical information about each patient, was retrospectively mailed to all referring labs that had sent
Matthew S. Karafin,
Gregory A. Denomme,
Michael Schanen,
Jerome L. Gottschall
Immunohematology, Volume 31 , ISSUE 3, 108–115
Case Study | 16-May-2020
suggest that DHTRs by a primary immune response may be considered even in the case of the patient who had typical evidence of hemolysis but who had no previous transfusion history.
Hyung Hoi Kim,
Tae Sung Park,
Seung Hwan Oh,
Chulhun L. Chang,
Eun Yup Lee,
Han Chul Son
Immunohematology, Volume 20 , ISSUE 3, 184–186
case-report | 30-September-2021
Hemolytic disease of the fetus and newborn (HDFN) occurs when the pregnant mother is alloimmunized with immunoglobulin (Ig)G-type antibodies specific for antigens present on the red blood cells (RBCs) of the fetus. These antibodies cross the placenta, and hemolysis occurs when the maternal antibody binds to the fetal RBC antigens, generating a binding to the Fc receptor of macrophages in the spleen of the fetus. After delivery, the continuous destruction of RBCs can cause progressive anemia and
M.A. Núñez Ahumada,
C.E. Arancibia Aros,
C.E. Villalobos Pavez,
F.M. Pontigo Gonzalez,
V. Abarca Arce,
M. Sandoval Medrano,
S. Reyes Jorquera
Immunohematology, Volume 37 , ISSUE 3, 122–125
Article | 10-April-2021
beats per minute [bpm]; normal range 60–100 bpm). Her body temperature rose from 37 to 38.1°C, and her O2 saturation level dropped to 75 percent (normal >95%). The transfusion was immediately stopped, and the patient was transferred to the intensive care unit. The blood gas analysis showed reduced PO2 and increased lactate, and the blood samples taken right after the transfusion reaction showed visible hemolysis. Laboratory tests showed normal haptoglobin, increased total bilirubin (TB), high levels
A. Espinosa,
L.J. Garvik,
N. Trung Nguyen,
B. Jacobsen
Immunohematology, Volume 37 , ISSUE 1, 20–24
Review | 09-October-2019
) status, and homozygosity or compound heterozygosity for null alleles is associated with the nonsecretor (se) status. H– individuals have natural anti-H (mostly IgM), which can cause severe hemolytic transfusion reactions with intravascular hemolysis.
Erwin Andreas Scharberg,
Coral Olsen,
Peter Bugert
Immunohematology, Volume 32 , ISSUE 3, 112–118
Case report | 01-December-2019
A 49-year-old white man with blood group AB, D+ was found to have alloanti-Jka and -K when he developed a delayed hemolytic transfusion reaction before allogeneic hematopoietic stem cell transplant (HSCT). Given that his stem cell donor was blood group O, D+, Jk(a+), K–, rituximab was added to his conditioning regimen of fludarabine and melphalan to prevent hemolysis of engrafting Jk(a+) donor red blood cells. The patient proceeded to receive a peripheral blood stem cell transplant from a
Miriam Y. Kim,
Preeti Chaudhary,
Ira A. Shulman,
Vinod Pullarkat
Immunohematology, Volume 29 , ISSUE 1, 11–14
Review | 01-April-2020
percent on day 2 after transfusion to strongly positive at 88 percent and 66.5 percent (with and without the addition of fresh serum) 1 week later. MMA reactivity of greater than 5 percent is associated with increased RBC destruction. There was no clinical or laboratory evidence of increased hemolysis above baseline. However,decreased RBC survival was suggested by the relatively brisk decrease of the HbA1 fraction after the transfusions. The current case and others reported in the literature suggest
Shan Yuan,
Nadia P. Ewing,
Debra Bailey,
Marissa Salvador,
Shirong Wang
Immunohematology, Volume 23 , ISSUE 2, 75–80
Report | 16-March-2020
more. However, the lack of nucleic acid testing for HIV and HCV may be problematic for old RBC units drawn from donors who were not subsequently tested for these markers, which is now mandatory in most countries. Regarding the 118 transfused RBC units older than 10 years, no evidence of hemolysis of thawed RBCs and no transfusion reaction, clinical or biologic hemolysis, or transfusion ineffectiveness was reported, either by any of the parties involved in the transfusion supply of rare RBC units or
Thierry Peyrard,
Bach-Nga Pham,
Pierre-Yves Le Pennec,
Philippe Rouger
Immunohematology, Volume 25 , ISSUE 1, 13–17
Case report | 15-April-2020
Views expressed in this article are those of the author and do not reflect the official policy or position of the Department of the Navy, Department of Defense, or U.S.Government. The only previously published case of anti-G in a pregnant woman indicated that anti-G alone caused little, if any, fetal or neonatal hemolysis. This report describes an affected fetus with amnionitic fluid OD 450 absorbance values in the moderate zone of the Liley prediction graph who required prolonged phototherapy
Aaron R. Huber,
George T. Leonard,
Rita W. Driggers,
Sakhone B. Learn,
Colleen W. Gilstad
Immunohematology, Volume 22 , ISSUE 4, 166–170
Case report | 30-November-2020
A gravida 3, para 1, 32-year-old black female presented at 27 weeks gestation for routine prenatal serologic tests. She typed as group A, D positive, category DIII mosaic. IgG1 anti-D, -hrB, and -E were identified in her serum. Ultrasound revealed an apparently normal fetus with no evidence of hydrops or ascites. Amniocentesis, performed at 30, 33, and 35 weeks, showed some evidence of hemolysis that did not increase over time. At 36 weeks of gestation, she delivered a full-term infant who
C. Faye Kugele,
Cindy K. Oliver,
Maria A. Carney,
Jayne Hollander
Immunohematology, Volume 10 , ISSUE 4, 124–126
Article | 16-October-2019
Polyagglutination is a condition in which red blood cells (RBCs) are agglutinated by normal adult human sera but not by autologous or newborn sera. Polyagglutination is caused by changes in the RBC membrane that enable patient RBCs to agglutinate with normal human sera; this agglutination can interfere with blood bank testing. Depending on the cause, polyagglutination may or may not be the cause of RBC hemolysis. Lectins and human sera can be used to detect polyagglutinable RBCs. Identification
Cami Melland,
Connie Hintz
Immunohematology, Volume 34 , ISSUE 3, 113–117
Article | 22-January-2021
Phagocytic index, %
Fresh complement
Donor 1
At(a+)
13.4
With
12.0
Without
Donor 2
At(a+)
13.8
With
16.1
Without
Patient (control)
At(a-)
0.2
Without
As shown in Table 1, all of the PI values of the two donors are over 10 percent, which indicates the anti-Ata might have been capable of causing hemolysis of transfused At(a+) RBCs in vivo. In addition, the PI values with or without fresh complement did not show a significant difference. The sensitization step with added fresh complement is
J. Gao,
S. Wise,
S.H. Tinsley,
J.F. Shikle
Immunohematology, Volume 36 , ISSUE 3, 104–107
Report | 09-October-2019
when tested with Ig-coated RBCs and the least amount of fluorescence when tested with naive RBCs. Tannic acid was used to prepare Ig-coated RBCs. Cross-reactivity of FITC-conjugated anti-IgG, -IgA, and -IgM with Ig-coated RBCs was evaluated, and a reference range was established. Use of this method may assist in clinical evaluation of patients who present with hemolysis and a negative direct antiglobulin test.
Wendy Beres,
Geralyn M. Meny,
Sandra Nance
Immunohematology, Volume 32 , ISSUE 4, 161–169
Article | 09-November-2020
. Umbilical cord blood testing revealed a panreactive eluate though the antibody was not detected in cord serum. The neonate’s mother was also found to have a positive DAT. A panagglutinin was identified in an eluate of her red cells, although the autoantibody could not be detected in her serum by a variety of sensitive techniques. There was no clinical or laboratory evidence of maternal hemolysis.
Terry D. Williamson,
Linda H. Liles,
Douglas P. Blackall
Immunohematology, Volume 13 , ISSUE 1, 6–8
Review | 14-March-2020
protein. The RBCs of people with the Cromer null phenotype, Inab, lack DAF but do not appear to demonstrate increased susceptibility to hemolysis. Antibodies to Cromer antigens are rarely encountered, although there is evidence that the antibodies may cause accelerated destruction of transfused RBCs. There is no risk of HDN associated with Cromer system antibodies because the placenta is a rich source of fetally derived DAF, which is thought to adsorb the antibodies.
Jill R. Storry,
Marion E. Reid,
Mark H. Yazer
Immunohematology, Volume 26 , ISSUE 3, 109–117
Article | 01-April-2020
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
Case report | 14-October-2020
phenotype of the patient as ccDEe. No hemolysis was evident, as judged by the absence of anemia, a bilirubin of 15.7 μmol/L, and lactic dehydrogenase of 412 IU/L. When an anti-D is identified in a D+ blood recipient, a passive transfer of anti-D, and an alloimmunization in a recipient with a weak D phenotype, should be ruled out. Finally, as in our case, an autoantibody is an additional possibility.
Joan Cid,
Victor Beltran,
L. Escoda,
Enric Elies,
Carmen Martin-Vega
Immunohematology, Volume 18 , ISSUE 1, 16–18
Article | 16-February-2021
M.R. George
Immunohematology, Volume 35 , ISSUE 4, 154–155
Article | 06-December-2020
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
Case report | 09-October-2019
, red blood cell units, compatible by electronic crossmatch, were issued and transfused. The subsequent transfusion reactions were characterized by acute intravascular hemolysis, evidenced by both clinical and laboratory criteria. These two cases demonstrate that, even when least anticipated, hemolytic transfusion reactions may occur. As expected, neither live-born neonate was affected by hemolytic disease of the fetus and newborn. Because both transfusion reactions occurred in non–group O
Marcia Marchese
Immunohematology, Volume 33 , ISSUE 3, 114–118
Article | 14-October-2020
samples were not included in this study. With a tube test, most of the antibodies had titers from 4 to 8. IgG subclass studies showed that 14 of 25 samples with reactive eluates contained IgG1, one contained IgG1+IgG2, one contained IgG1+IgG4, and two contained IgG1+IgG3 weak. The frequency of donors with a positive direct antiglobulin test (DAT) was ~ 1 in 3000 and males were twice as likely to be DAT positive (8 females vs. 17 males in this study). None of the donors had hemolysis. Two donors showed
Marianna Bellia,
John Georgopoulos,
Vasilis Tsevrenis,
Efrosini Nomikou,
Niki Vgontza,
I. Kontogpoulous-Griva
Immunohematology, Volume 18 , ISSUE 3, 78–81
Article | 20-December-2020
unusual characteristic seen in both of these cases was hemolysis in the EDTA cell samples but none in the clotted samples.
Teresa Y. Harris
Immunohematology, Volume 6 , ISSUE 4, 87–91
Article | 14-October-2020
pretransfusion samples were tested as they were received (from May 1998 to December 1999), in 37°C saline and by IAT using the DiaMed gel system. The screening tests were performed using 50 µL of 0.8% low-ionic-strength saline suspended RBCs and 50 µL of plasma. The tests were examined for agglutination and hemolysis. Two hundred and thirty three samples (9.81%) were reactive by IAT and 88 (3.70%) by 37°C saline. All 88 samples reactive by 37°C saline also reacted by IAT. These data
José A. Duran,
Manuel Figueiredo
Immunohematology, Volume 18 , ISSUE 1, 13–15
Article | 14-October-2020
Randal B. Covin,
Karen S. Evans,
Richard Olshock,
Hannis W. Thompson
Immunohematology, Volume 17 , ISSUE 2, 45–49
Article | 06-December-2020
(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 | 14-October-2020
Paroxysmal nocturnal hemoglobinuria (PNH), an acquired stem cell defect, is underdiagnosed because of its atypical symptoms in some patients and because available methods, which are time consuming and complicated, are not widely used. The hemolysis of PNH red blood cells (RBCs) is attributed to their enhanced susceptibility to complement lysis caused by a deficiency in glycosylsphosphatidylinositol (GPI)-anchored complement regulatory membrane proteins, especially membrane inhibitor of reactive
Barbara Zupanska,
Irena Bogdanik,
Hanna Pyl
Immunohematology, Volume 18 , ISSUE 1, 9–12
Article | 09-November-2020
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 | 10-April-2021
patient’s plasma. Assuming this antibody could have been anti-S, and to avoid alloimmunization to E, RBC units transfused were also S– and E–.
Another RBC unit was requested 6 days later for an Hb of 9.3 g/dL. The crossmatch was weakly positive. Additional studies revealed the presence of anti-D and -C and an apparent alloantibody to the HPA. Findings of the serologic investigation were communicated to the clinic. Laboratory parameters were negative for hemolysis (total bilirubin [TB] 20 µmol/L, normal
M. Raos,
N. Thornton,
M. Lukic,
B. Golubic Cepulic
Immunohematology, Volume 37 , ISSUE 1, 13–17
Article | 09-November-2020
Although antibodies to the Dib antigen are generally considered to be of potential clinical significance, we know of no reports assessing the clinical significance of anti-Dib (in vivo or in vitro). We report on an 88-year-old Japanese male gastrectomy patient who had alloanti-Dib. After transfusion of two Di(b–) units, three Di(b+) units had to be transfused, and there were no clinical signs of acute hemolysis. Di(b+) RBC survival was followed retrospectively by flow cytometry. On days 1
Regina M. Leger,
Patricia A. Arndt,
Asuncion Co,
Lauren O’Brien,
George Garratty
Immunohematology, Volume 13 , ISSUE 3, 93–96
Report | 14-March-2020
positive DAT than nonalloimmunized patients, but this association was not significant (OR, 2.2; p = 0.11). A positive DAT did not correlate with decreased response to transfusion, RBC survival, hemolysis, or increased transfusion requirements. Only two cases of early alloimmunization were detected by DAT among 288 DATpositive samples studied during 4 years. This study demonstrated that the routine performance of DATs on pretransfusion specimens in thalassemic patients has limited clinical utility, and
Suzanne A. Arinsburg,
Donna L. Skerrett,
Dorothy Kleinert,
Patricia J. Giardina,
Melissa M. Cushing
Immunohematology, Volume 26 , ISSUE 3, 87–91
Case report | 09-October-2019
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 | 22-November-2020
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 | 06-December-2020
A patient who expired during an episode of gross intravascular hemolysis had a complex medical history, including renal disease, Coombs positive anemia of unclear etiology, recent transfusion, and cholecystectomy. Drug history included 21 different medications, including penicillin, acetaminophen, procainamide, furosemide, sulindac, and tolmetin, all of which have been associated with a positive direct antiglobulin test or drug-induced hemolytic anemia. The patient had a history of recent use
Nancy I. Maddox,
Debra Futral,
Floyd T. Boudreau
Immunohematology, Volume 8 , ISSUE 3, 70–76
Article | 03-November-2020
268 by both saline-IAGTs and RAM-IAGTs. The four antibodies that were not detected were identified as anti-D, anti-E, anti-Bga, and an autoantibody known previously to be only reactive with papain-pretreated red cells. No nonspecific reactions were detected by PEG-IAGTs and no hemolysis was evident in any of the IAGTs. PEG-IAGTs were more sensitive than saline- and RAM-IAGTs. PEG-IAGTs detected all weak, clinically significant antibodies as well as four antibodies that were otherwise undetected by
Kim Swee Low,
Yew-Wah Liew,
Peter M. Bradley
Immunohematology, Volume 14 , ISSUE 2, 68–71
Article | 17-February-2021
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
original-report | 25-June-2021
Cryopreservation of red blood cell (RBC) concentrates is used for long-term storage of rare phenotyped RBCs to provide life-saving therapies to patients. To produce these components in Canada, blood manufacturers must demonstrate that the production method they use yields RBC units that meet regulatory guidelines for hemolysis, hemoglobin (Hgb) content, and RBC recovery.1 The Canadian Blood Services (CBS) Rare Blood Program maintains a carefully selected inventory of cryopreserved RBCs with
T.R. Turner,
G. Clarke,
G.A. Denomme,
R. Skeate,
J.P. Acker
Immunohematology, Volume 37 , ISSUE 2, 78–83
Case report | 09-October-2019
Polyagglutination is a rare and underdiagnosed condition, characterized by agglutination of red blood cells (RBCs) with almost all ABO-compatible adult sera. Polyagglutination can occur when a cryptantigen is exposed on RBCs via microbial enzyme activity. Because nearly all adults naturally produce antibodies against cryptantigens, transfusion of plasma can cause unexpected hemolysis and hematologic complications, such as thrombocytopenia and disseminated intravascular coagulation, in patients
Ryan P. Jajosky,
Lloyd O. Cook,
Elizabeth Manaloor,
James F. Shikle,
Roni J. Bollag
Immunohematology, Volume 33 , ISSUE 2, 51–55
Case report | 26-October-2019
laboratory for further testing. Results from the reference lab testing revealed the presence of anti-Jk3 in the patient’s serum. The patient was placed on steroids, and his reticulocyte count increased with no further signs of extravascular hemolysis. No additional transfusions were necessary. He was eventually discharged with a hemoglobin of 13.6 g/dL. The purpose of this case study is to report the findings of an extremely rare but clinically significant antibody, anti-Jk3.
Shaina McCaskill,
Scott Wise,
Sheila Tinsley
Immunohematology, Volume 31 , ISSUE 3, 119–122