Maternal Red Cell Alloantibody Directed Against a High Incidence Antigen

Objective: To determine the incidence and the rate of red blood cell alloimmunization in polytransfused patients. Methods: A polytransfused patient was defined as having received at least 6 units of red cell concentrates during a 3-month period. The records of all patients (n = 12,904) who had received red blood cell units were examined retrospectively by searching the computer database at Hospital Israelita Albert Einstein in São Paulo, Brazil, over a 6-year period, between 2003 and 2009. Results: During this time, 77,049 red cell concentrate transfusions were performed in 12,904 patients. There were 3,044 polytransfused patients, 227 of whom (7.5%) presented with irregular erythrocyte antibodies. The prevalence of alloantibody specificity was: Anti-E>anti-D>anti-K>anti-C>anti-Dia>anti-c>anti-Jka>anti-S in 227 polytransfused patients. We found combinations of alloantibodies in 79 patients (34.8%), and the most common specificities were against the Rh and/or Kell systems. These antibodies show clinical significance, as they can cause delayed hemolytic transfusion reactions and perinatal hemolytic disease. About 20% of the patients showed an IgG autoantibody isolated or combined with alloantibodies. Interestingly, a high incidence of antibodies against low frequency antigens was detected in this study, mainly anti-Dia. Conclusion: Polytransfused patients have a high probability of developing alloantibodies whether alone or combined with autoantibodies and antibodies against low frequency antigens. Transfusion of red blood cells with a phenotype-compatible with RH (C, E, c), K, Fya, and Jka antigens is recommended for polytransfused patients in order to prevent alloimmunization and hemolytic transfusion reactions.

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roles of carrier proteins. The identification and usefulness of blood group antigens as markers will be described and possible explanations for their variation in expression will be discussed. Most red cell antigens have been investigated because they are clinically important [1]. The antibodies to some antigens have caused haemolytic disease of the newborn and/or transfusion reactions. Other antigens are involved in haemolytic anaemia and some are important in transplantation. Red cell antigens provided a tool for investigation of the red cell surface and for use as genetic, immunological and biochemical markers. More than 500 red cell antigens are serologically defined, about half of which have been officially recognised and have been numbered by the International Society of Blood Transfusion Working Party on Terminology for Red Cell Surface Antigens [2,3]. Antigens are divided into systems (antigens controlled by a locus or closely linked loci) and three holding files: collections (related antigens whose genetic relationship is unknown), antigens of high incidence or antigens of low incidence. THE MAIEA TECHNIQUE Sometimes if an antigen has a very high or a very low incidence it is hard to relate it to other antigens or to assign it to a system. Immunochemical studies and in the case of high incidence antigens, use of cells of rare phenotype can be informative and recently the MAIEA technique, monoclonal antibody specific immobilisation of erythrocyte antigens, has proved useful. MAIEA was an adaptation of a technique, MAIPA, frequently used for studying platelets. MAIEA can be used to assign red cells antigens, as recognised by human alloantisera, to particular components of the red cell membrane [4]. Location of antigens on specific red cell membrane components The Knops system consists of 4 high incidence antigens Kna, McCa, Sla and Yka with frequencies greater than 90% in populations tested. There is also a low incidence antigen Knb found in Whites [3]. The antibodies to these public antigens are difficult to identify serologically. The antigens show a wide variation of strength on different donor’s cells. There is a null phenotype, the Helgeson phenotype, which appears from serological tests to lack all 4 antigens [5]. Cells which lack one Knops antigen may have weakened expression of other Knops antigens. The mists about these serologically difficult antigens were cleared when Moulds et al [6] and Rao et al [7] independently showed that these antigens were carried on the CR1 (complement receptor 1, CD35) protein. The related antigen Csa was not located on CR1, so Csa and Csb were left in the Cost collection [3].

Transfusion Immunology and Medicine ◽

10.1201/9781482273441-7 ◽

1995 ◽

pp. 188-188

Keyword(s):

Cell Membrane ◽

Cell Surface ◽

Working Party ◽

Red Cell ◽

Cell Surface Antigens ◽

Serological Tests ◽

Red Cell Membrane ◽

Red Cell Antigens ◽

High Incidence ◽

Low Incidence

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A case of pure red cell aplasia with a high incidence of spontaneous chromosome breakage: A possible X-ray sensitive syndrome

Human Genetics ◽

10.1007/bf00290214 ◽

1980 ◽

Vol 55 (3) ◽

pp. 337-340 ◽

Cited By ~ 11

Author(s):

O. Iskandar ◽

M. J. Jager ◽

R. Willenze ◽

A. T. Natarajan

Keyword(s):

Chromosome Breakage ◽

Pure Red Cell Aplasia ◽

Red Cell ◽

X Ray ◽

Red Cell Aplasia ◽

High Incidence ◽

Spontaneous Chromosome

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The orientation of sickle hemoglobin fibers within fascicles

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100104066 ◽

1988 ◽

Vol 46 ◽

pp. 400-401

Author(s):

Christopher A. Miller ◽

Bridget Carragher ◽

William A. McDade ◽

Robert Josephs

Keyword(s):

Sickle Cell ◽

Sickle Cell Anemia ◽

Relative Orientation ◽

Unit Cell ◽

Red Cell ◽

High Ph ◽

Sickle Hemoglobin ◽

Polar Crystal ◽

Helical Configuration

Highly ordered bundles of deoxyhemoglobin S (HbS) fibers, termed fascicles, are intermediates in the high pH crystallization pathway of HbS. These fibers consist of 7 Wishner-Love double strands in a helical configuration. Since each double strand has a polarity, the odd number of double strands in the fiber imparts a net polarity to the structure. HbS crystals have a unit cell containing two double strands, one of each polarity, resulting in a net polarity of zero. Therefore a rearrangement of the double strands must occur to form a non-polar crystal from the polar fibers. To determine the role of fascicles as an intermediate in the crystallization pathway it is important to understand the relative orientation of fibers within fascicles. Furthermore, an understanding of fascicle structure may have implications for the design of potential sickling inhibitors, since it is bundles of fibers which cause the red cell distortion responsible for the vaso-occlusive complications characteristic of sickle cell anemia.

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Erythrophagocytosis in the Liver in Hemolytic Anemias

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100100664 ◽

1968 ◽

Vol 26 ◽

pp. 184-185

Author(s):

O. T. Minick ◽

E. Orfei ◽

F. Volini ◽

G. Kent

Keyword(s):

Acid Phosphatase ◽

Oxidative Damage ◽

Phosphatase Activity ◽

Kupffer Cells ◽

Acid Phosphatase Activity ◽

Common Type ◽

Red Cell ◽

Cell Fragments ◽

Reticulo Endothelial System ◽

Important Site

Hemolytic anemias were produced in rats by administering phenylhydrazine or anti-erythrocytic (rooster) serum, the latter having agglutinin and hemolysin titers exceeding 1:1000.Following administration of phenylhydrazine, the erythrocytes undergo oxidative damage and are removed from the circulation by the cells of the reticulo-endothelial system, predominantly by the spleen. With increasing dosage or if animals are splenectomized, the Kupffer cells become an important site of sequestration and are greatly hypertrophied. Whole red cells are the most common type engulfed; they are broken down in digestive vacuoles, as shown by the presence of acid phosphatase activity (Fig. 1). Heinz body material and membranes persist longer than native hemoglobin. With larger doses of phenylhydrazine, erythrocytes undergo intravascular fragmentation, and the particles phagocytized are now mainly red cell fragments of varying sizes (Fig. 2).

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The observation of defects on (100) CdTe surfaces by chemical etching

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100131759 ◽

1992 ◽

Vol 50 (2) ◽

pp. 1424-1425

Author(s):

M.E. Lee

Keyword(s):

Single Crystal ◽

Grain Boundaries ◽

Single Crystals ◽

Chemical Etching ◽

Crystalline Perfection ◽

Crystalline Defects ◽

High Incidence ◽

Crystallographic Defects ◽

Cdznte Substrates ◽

Device Technology

The crystalline perfection of bulk CdTe substrates plays an important role in their use in infrared device technology. The application of chemical etchants to determine crystal polarity or the density and distribution of crystallographic defects in (100) CdTe is not well understood. The lack of data on (100) CdTe surfaces is a result of the apparent difficulty in growing (100) CdTe single crystal substrates which is caused by a high incidence of twinning. Many etchants have been reported to predict polarity on one or both (111) CdTe planes but are considered to be unsuitable as defect etchants. An etchant reported recently has been considered to be a true defect etchant for CdTe, MCT and CdZnTe substrates. This etchant has been reported to reveal crystalline defects such as dislocations, grain boundaries and inclusions in (110) and (111) CdTe. In this study the effect of this new etchant on (100) CdTe surfaces is investigated.The single crystals used in this study were (100) CdTe as-cut slices (1mm thickness) from Bridgman-grown ingots.

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