Systematic Analysis of Direct Antiglobulin Test Results in Post-artesunate Delayed Hemolysis

2020 ◽  
Author(s):  
Tommaso Ascoli Bartoli ◽  
Luciana Lepore ◽  
Alessandra D'Abramo ◽  
Giovanna Adamo ◽  
Angela Corpolongo ◽  
...  
Keyword(s):  
Univariate Analysis ◽  
Case Series ◽  
Direct Antiglobulin Test ◽  
Systematic Analysis ◽  
Immune Mediated ◽  
Pubmed Database ◽  
Antiglobulin Test ◽  
Erythrocyte Clearance ◽  
Kinetics Of

Abstract Background: “Post-Artesunate Delayed Hemolysis” (PADH) is common after severe malaria episodes. PADH is related to the “pitting” phenomenon and the synchronous delayed clearance of once-infected erythrocytes, initially spared during treatment. However, direct antiglobulin test (DAT) positivity has been reported in several PADH cases, suggesting a contribution of immune-mediated erythrocyte clearance. The aim of the present study was to compare clinical features of cases presenting a positive or negative DAT.Method: Articles reporting clinical data of patients diagnosed with PADH, for whom DAT had been performed, were collected from PubMed database. Data retrieved from single patients were extracted and univariate analysis was performed in order to identify features potentially related to DAT results and steroids use.Results: Twenty-two studies reporting 39 PADH cases were included: median baseline parasitemia was 20.8% (IQR: 11.2-30) and DAT was positive in 17 cases (45.5%). Compared to DAT-negative individuals, DAT-positive patients were older (49.5 vs 31; p=0.01), had a higher baseline parasitemia (27% vs 17%; p=0.03) and were more commonly treated with systemic steroids (11 vs 3 patients, p=0.002). Depth and kinetics of delayed anemia were not associated with DAT positivity.Conclusions: In this case series, almost half of the patients affected by PADH had a positive DAT. An obvious difference between the clinical courses of patients presenting with a positive or negative DAT was lacking. This observation strongly suggests that DAT result is not indicative of a pathogenic role of anti-erythrocytes antibodies in patients affected by PADH, but is rather a marker of immune activation.

scholarly journals Systematic analysis of direct antiglobulin test results in post-artesunate delayed haemolysis

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Tommaso Ascoli Bartoli ◽  
Luciana Lepore ◽  
Alessandra D’Abramo ◽  
Giovanna Adamo ◽  
Angela Corpolongo ◽  
...  
Keyword(s):  
Univariate Analysis ◽  
Case Series ◽  
Direct Antiglobulin Test ◽  
Systematic Analysis ◽  
Immune Mediated ◽  
Pubmed Database ◽  
Antiglobulin Test ◽  
Delayed Haemolysis ◽  
Erythrocyte Clearance

Abstract Background Post-artesunate delayed haemolysis (PADH) is common after severe malaria episodes. PADH is related to the “pitting” phenomenon and the synchronous delayed clearance of once-infected erythrocytes, initially spared during treatment. However, direct antiglobulin test (DAT) positivity has been reported in several PADH cases, suggesting a contribution of immune-mediated erythrocyte clearance. The aim of the present study was to compare clinical features of cases presenting a positive or negative DAT. Methods Articles reporting clinical data of patients diagnosed with PADH, for whom DAT had been performed, were collected from PubMed database. Data retrieved from single patients were extracted and univariate analysis was performed in order to identify features potentially related to DAT results and steroids use. Results Twenty-two studies reporting 39 PADH cases were included: median baseline parasitaemia was 20.8% (IQR: 11.2–30) and DAT was positive in 17 cases (45.5%). Compared to DAT-negative individuals, DAT-positive patients were older (49.5 vs 31; p = 0.01), had a higher baseline parasitaemia (27% vs 17%; p = 0.03) and were more commonly treated with systemic steroids (11 vs 3 patients, p = 0.002). Depth and kinetics of delayed anaemia were not associated with DAT positivity. Conclusions In this case series, almost half of the patients affected by PADH had a positive DAT. An obvious difference between the clinical courses of patients presenting with a positive or negative DAT was lacking. This observation suggests that DAT result may not be indicative of a pathogenic role of anti-erythrocytes antibodies in patients affected by PADH, but it may be rather a marker of immune activation.

Gut Microbiota and Autoimmune Diseases: a Charming Real World Together with Probiotics

2021 ◽  
Vol 28 ◽  
Author(s):  
Andrea Piccioni ◽  
Sara Cicchinelli ◽  
Federico Valletta ◽  
Giulio De Luca ◽  
Yaroslava Longhitano ◽  
...  
Keyword(s):  
Autoimmune Disease ◽  
Gut Microbiota ◽  
English Language ◽  
Meta Analysis ◽  
Clinical Manifestations ◽  
Case Series ◽  
Case Evaluation ◽  
Immune Mediated ◽  
Keywords Autoimmunity

Background: The role of gut microbiota in human disease is fascinating for hundreds of researchers worldwide. Many works have highlighted that gut microbiota modulates the immune system, and that its disruption can trigger autoimmune and inflammatory immune-mediated diseases. Probiotics are able to positively modify microbiota composition. Objective: Aim of this review is to report the most important findings regarding the effects of probiotics administration in the most common autoimmune disease and inflammatory immune-mediated diseases. Method: Literature research was performed in PubMed, Google Scholar and Medline, as well as in specific journal websites using the keywords: “autoimmunity”, “microbiota”, and “probiotics”. The article selection has been made independently by three authors, and controversies have been solved by a fourth researcher. Only English-language articles were included and preference was given to clinical trials, meta-analysis, and case series. After the review process, 68 articles have been considered. Results: Relying on this evidence, many studies have investigated the potential of probiotics in restoring gut eubiosis thus affecting pathogenesis, clinical manifestations, and course of these pathologies. Even in the light of few and sometimes contradictory studies, physicians should start to consider this preliminary findings when approaching patients suffering from autoimmune disease. After an accurate case-by-case evaluation of potential candidates, probiotics might be introduced beside the standard therapeutic plan, as supportive measures.

scholarly journals Complete Remission of Associative Immune-Mediated Hemolytic Anemia in a Dog Following Surgical Resection of Intestinal Leiomyosarcoma

2019 ◽  
Vol 6 (2) ◽  
pp. 55
Author(s):  
Masashi Yuki ◽  
Eiji Naitoh
Keyword(s):  
Complete Remission ◽  
Surgical Resection ◽  
Hemolytic Anemia ◽  
Immunosuppressive Treatment ◽  
Abdominal Ultrasound ◽  
Direct Antiglobulin Test ◽  
Intestinal Neoplasm ◽  
Immune Mediated ◽  
Antiglobulin Test ◽  
Veterinary Hospital

A twelve-year-old male castrated Chihuahua with a severe, microcytic, hypochromic, and nonregenerative direct antiglobulin test positive anemia characterized by marked spherocytosis was referred to the veterinary hospital. Abdominal ultrasound revealed a peritoneal mass of unclear origin. Transfusion, followed by mass resection, rapidly resolved the anemia without further immunosuppressive treatment. Histopathology confirmed extraluminal jejunal leiomyosarcoma. Multiple mechanisms, including immune-mediated destruction, likely contributed to the anemia. To the authors’ knowledge, this is the first report that describes the resolution of immune-mediated hemolysis in a dog after the removal of an intestinal neoplasm.

scholarly journals Coombs-positive Paroxysmal Nocturnal Haemoglobinuria

2020 ◽  
Vol 2020 (3) ◽  
Author(s):  
Sabrina Kalam ◽  
Rupert Beale ◽  
Derralynn Hughes ◽  
Austin Kulasekararaj ◽  
Umasuthan Srirangalingam
Keyword(s):  
Haemolytic Anaemia ◽  
Treatment Strategies ◽  
Paroxysmal Nocturnal Haemoglobinuria ◽  
Direct Antiglobulin Test ◽  
Autoimmune Haemolytic Anaemia ◽  
Coombs Test ◽  
Immune Mediated ◽  
Antiglobulin Test ◽  
Work Up

Abstract Autoimmune haemolytic anaemia (AIHA) and paroxysmal nocturnal haemoglobinuria (PNH) are two distinct causes of haemolytic anaemia. They have different mechanisms that underpin their pathogenesis and, therefore, require different treatment strategies. The direct antiglobulin test (DAT) or Coombs test is positive in cases of immune-mediated haemolytic anaemia and, thus, is positive in AIHA but negative in PNH. We report a case of a woman presenting with a haemolytic anaemia who was found to have concomitant evidence of AIHA and PNH. The case highlights the importance of carrying out a comprehensive haemolysis work-up in patients who present with haemolytic anaemia.

scholarly journals Sex Disparity in Food Allergy: Evidence from the PubMed Database

2009 ◽  
Vol 2009 ◽  
pp. 1-7 ◽  
Author(s):  
Caleb Kelly ◽  
Venu Gangur
Keyword(s):  
Food Allergy ◽  
Food Allergies ◽  
Female Ratio ◽  
Immune Mediated ◽  
Pubmed Database ◽  
Male Female Ratio ◽  
Ige Mediated ◽  
Sex Disparity ◽  
The Relationship

Food allergies are potentially fatal immune-mediated disorders that are growing globally. The relationship between sex and food allergy remains incompletely understood. Here we tested the hypothesis that, should sex influence the clinical response to food allergens, this would be reflected by a sex disparity in published studies of food allergy. We performed a systematic search of the PubMed literature for IgE-mediated allergy to 11 allergenic foods of international regulatory importance. No date restriction was used and only articles in English were considered. Of the 4744 articles retrieved, 591 met the inclusion criteria representing 17528 subjects with food allergies. Whereas among children with food allergies, 64.35% were males and 35.65% were females (male/female ratio, 1.80), among adults 34.82% were males and 65.18% were females (male/female ratio, 0.53). Consequently, these data argue that there is need for further investigation to define the role of sex in the pathogenesis of food allergy.

scholarly journals Application of a Direct Flow Cytometric Erythrocyte Immunofluorescence Assay in Dogs with Immune-Mediated Hemolytic Anemia and Comparison to the Direct Antiglobulin Test

2001 ◽  
Vol 13 (4) ◽  
pp. 297-300 ◽  
Author(s):  
Kelley A. Quigley ◽  
Brian J. Chelack ◽  
Deborah M. Haines ◽  
Marion L. Jackson
Keyword(s):  
Hemolytic Anemia ◽  
Cost Effective ◽  
Immunofluorescence Assay ◽  
Direct Antiglobulin Test ◽  
Complement C3 ◽  
Direct Flow ◽  
Flow Cytometric ◽  
Immune Mediated ◽  
Antiglobulin Test ◽  
Healthy Dogs

A direct flow cytometric erythrocyte immunofluorescence assay (FC) was developed and compared with the direct antiglobulin test (DAT) for detection of erythrocyte-bound immunoglobulin (IgG and IgM) and complement (C3) in dogs with immune-mediated hemolytic anemia (IMHA). Tests were performed on erythrocytes from 13 healthy nonanemic dogs and from 13 anemic dogs with IMHA. The FC and DAT were negative for erythrocyte-bound immunoglobulin in all healthy dogs. The FC was negative for erythrocyte-bound C3 in 12 healthy dogs and positive in 1 healthy dog, and the DAT was negative for C3 in all healthy dogs. Of the 13 IMHA dogs tested for erythrocyte-bound IgG, 12 were positive using the FC and 7 were positive using the DAT. Sensitivity for the detection of erythrocyte-bound IgG in the 26 dogs was 92% for FC and 53% for DAT. Specificity for detection of erythrocyte bound IgG for FC and DAT was 100%. The addition of IgM and/ or C3 did not increase the sensitivity for FC or DAT. In this group of dogs, the FC provided a more rapid, cost-effective, sensitive, objective method to quantitate erythrocyte-bound immunoglobulin and/or complement compared with the currently used DAT.

scholarly journals Severe Hemolysis With Negative Direct Antiglobulin Test: A Case Report

2021 ◽  
Author(s):  
Mahin Behzadi Fard ◽  
Ali Arianezhad ◽  
Ali Bandehzadeh
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Emergency Department ◽  
Type 2 Diabetes Mellitus ◽  
Total Bilirubin ◽  
Vital Signs ◽  
Direct Antiglobulin Test ◽  
Immune Mediated ◽  
Antiglobulin Test

Abstract A 49-year-old woman with type 2 diabetes mellitus presented to the emergency department. Her examination showed marked pallor, exhaustion, lethargy, yellowish eyes, anorexia, nausea and vomiting. Laboratory analysis revealed: Hemoglobin (Hb) 4.8 g/dl, MCV 91fl, platelet count 233 × 106 /L, Total bilirubin 7.0 mg/dl, Glucose 316 mg/dl, hematuria and normal G6PD. Hemolytic panel was unswerving with hemolysis. IV fluids and 2 units of packed cell were transfused. Despite transfusion, during the first 4 days of hospitalization the hemolysis continued so that immune hemolysis was suspected in spite of negative coomb's test. After 3 weeks of the patient refer to the hospital, she was discharged home with stable vital signs and Hb10 g/dl. Blood transfusion along with corticosteroids, IVIG and rituximab saved the life of this patient. We concluded in cases that presented with a severe drop in hemoglobin, even if there is a negative direct antiglobulin test (DAT) pay special attention to the immune mediated hemolysis and do not be misled with a negative coomb's test.

A case series of pediatric patients with direct antiglobulin test negative autoimmune hemolytic anemia

Transfusion ◽  
2019 ◽  
Vol 59 (8) ◽  
pp. 2528-2531 ◽  
Author(s):  
Jonathan Miller ◽  
Wei Cai ◽  
Jennifer Andrews ◽  
Anupama Narla
Keyword(s):  
Hemolytic Anemia ◽  
Autoimmune Hemolytic Anemia ◽  
Pediatric Patients ◽  
Case Series ◽  
Direct Antiglobulin Test ◽  
Antiglobulin Test

Relationship between Micro-/Nano-Structure and Stress Development in TM-Doped Mg-Based Alloys Absorbing Hydrogen

2012 ◽  
Vol 194 ◽  
pp. 237-244 ◽  
Author(s):  
N.E. Skryabina ◽  
Vladimir M. Pinyugzhanin ◽  
Daniel Fruchart
Keyword(s):  
Hydrogen Absorption ◽  
Mechanical Parameters ◽  
Systematic Analysis ◽  
Nano Structure ◽  
Early Transition Metal ◽  
Crystallite Sizes ◽  
External Stresses ◽  
The Impact ◽  
Kinetics Of

In the most recent years, MgH2has attracted considerable attention for reversible hydrogen storage purposes because of a large 7.6 w% H-uptake, single plateau reaction at low pressure and abundance of metal. If the Mg ↔ H reactions take place at rather high temperature (> 300°C), the kinetic remains very low. However, early transition metal based additives (Ti, V, Nb...) improve dramatically the kinetics of hydrogen absorption/desorption, while having no essential impact on the reversible sorption capacity. Systematic analysis of many experimental data led to question chemical, physical, mechanical... parameters contributing significantly to improve the kinetics of absorption/desorption. Besides, results of theoretical and numerical computation enlighten the impact of structural and mechanical parameters owing to the local bonds of Mg/MgH2with of TM elements, in terms of total energy and electronic structure. More specifically, we found highly relevant to consider 1 - the impact of the crystallite sizes of Mg and the TM-phase, 2 - the role of internal and external stresses, as well as 3 - the role of texture on the kinetics of hydrogen absorption/desorption. Apart the previous considerations, we like to underline the role of specific TM in trapping intermediately hydrogen thus forming TMHxprior initiating the Mg ↔ MgH2nucleation process.

Sign in / Sign up

Export Citation Format

Share Document