Harris T
Pacific Northwest Red Cross Regional Blood Services, 3131 North Vancouver Avenue, Portland, OR 97208, USA.
Immunohematology. 1990;6(4):87-91.
Two transfused Caucasian patients presented with possible delayed transfusion reactions. Both patients demonstrated an anti-Fya (Fy1) plus anti-Fyb (Fy2) pattern of reactivity in their sera. The patients' red blood cells (RBCs) were Fy:1,-2,3. Both had positive direct antiglobulin tests (DAT) with anti-IgG and -C3d. The serum antibodies reacted with the patients' RBCs drawn when the DATs were negative Both patients' serum samples showed reactivity with Fy:1,-2 (1+), Fy:-1,2 (3+), Fy:1,2 (3+) RBCs at the antiglobulin phase (AGT) but were nonreactive with Fy: -1, -2 RBCs. The antibodies in both cases were nonreactive with papain- or ficin-treated RBCs and reacted with Rhnull RBCs, which ruled out anti-Fy3 and anti-Fy 5 respectively. These cases suggest mimicking autoantibody specificities in the Duffy system one case may indicate that the degree of reactivity is dependent on the Duffy phenotype of the RBCs tested( Fy:-1,2 > Fy:1,2 > Fy: 1,-2). An unusual characteristic seen in both of these cases was hemolysis in the EDTA cell samples but none In the clotted samples.
两名接受输血的白种人患者出现了可能的迟发性输血反应。两名患者的血清均显示出抗Fya（Fy1）加抗Fyb（Fy2）的反应模式。患者的红细胞（RBC）为Fy:1,-2,3。两人的直接抗球蛋白试验（DAT）对抗IgG和-C3d均呈阳性。当DAT为阴性时，血清抗体与采集的患者红细胞发生反应。两名患者的血清样本在抗球蛋白阶段（AGT）与Fy:1,-2（1+）、Fy:-1,2（3+）、Fy:1,2（3+）红细胞发生反应，但与Fy:-1,-2红细胞无反应。两例中的抗体与木瓜蛋白酶或 ficin处理的红细胞无反应，但与Rhnull红细胞发生反应，分别排除了抗Fy3和抗Fy5。这些病例提示在达菲系统中存在模拟自身抗体特异性的情况，其中一例可能表明反应程度取决于所检测红细胞的达菲表型（Fy:-1,2 > Fy:1,2 > Fy:1,-2）。这两例中均出现的一个不寻常特征是EDTA细胞样本中有溶血现象，而凝血样本中无溶血现象。
