Devenish A
Reference Laboratory, North London Blood Transfusion Centre, Colindale Avenue, Colindale, London NW9 5BG, UK.
Immunohematology. 1994;10(4):127-9.
Blood samples from a 10-month-old male infant requiring transfusion were found to contain an allomtibody reacting at 37 degrees C in saline, by indirect antiglobulin test (IAT), and with a manual polybrene technique. Preliminary results suggested anti-D and another weaker reacting antibody, but the patient had been previously transfused with only D- blood. His serum reacted more weakly by IAT against red cells treated with 0.2M dithiothreitol (DTT), and one D+, LW(a-) sample was nonreactive. The patient's red blood cells (RBCs) typed as B, D-, LW(a-), K-, Fy(a-). Due to the age and clinical status of the child, 51Cr survival studies were not performed. One pediatric unit of D-, K-, Fy(a-) blood was transfused uneventfully; the expected increment of hemoglobin was achieved. Repeat testing 3 months later showed a weakly positive DAT, the patient's RBCs typed as LW(a+), and anti-LWa was detected only by a two-stage papain technique. These results suggest that the patient had a transient depression of LWa with a concurrent anti-LWa.
一名10个月大需要输血的男婴的血样，通过间接抗球蛋白试验（IAT）和手工聚凝胺技术检测发现，其含有一种在37℃生理盐水中发生反应的同种抗体。初步结果提示存在抗-D及另一种反应较弱的抗体，但该患者此前仅输注过D阴性血。其血清通过IAT对用0.2M二硫苏糖醇（DTT）处理过的红细胞反应更弱，且一份D阳性、LW(a-)样本无反应。该患者的红细胞（RBC）血型为B、D阴性、LW(a-)、K阴性、Fy(a-)。由于患儿的年龄和临床状况，未进行51Cr存活研究。输注了一个单位的D阴性、K阴性、Fy(a-)血型的儿科用血液，输注过程顺利；血红蛋白达到了预期的增量。3个月后复查显示直接抗球蛋白试验（DAT）弱阳性，患者的RBC血型为LW(a+)，且仅通过两阶段木瓜蛋白酶技术检测到抗-LWa。这些结果提示该患者存在LWa的短暂性降低并伴有同时存在的抗-LWa。
