Ahrens Norbert, Pruss Axel, Kähne Andreas, Kiesewetter Holger, Salama Abdulgabar
Institute for Transfusion Medicine, Charité-University Medicine, Berlin, Germany.
Transfusion. 2007 May;47(5):813-6. doi: 10.1111/j.1537-2995.2007.01194.x.
Autoantibodies (AUTO) to red blood cells (RBCs) are frequently associated with alloantibodies (ALLO). The mechanism for the coexistence of these antibodies is obscure.
Between August 1998 and June 2006, all in- and outpatients of the Charité University Hospital, Berlin, with detectable AUTO were included in this study. Serologic examination was performed with standard techniques for the detection of RBC antibodies.
A total of 717 patients were found to have AUTO, with ALLO observed in 200 of these patients (28%). The history of antibody production could be evaluated in 98 of the 200 patients. Both AUTO and ALLO were due to RBC transfusion in 73 cases (75%) and peripheral blood progenitor cell transplantation in 6 cases (6%). Nine (9%) patients were primarily alloimmunized and subsequently developed AUTO. The remaining 10 (10%) patients were primarily autoimmunized and later developed ALLO. Only 6 of these patients had chronic idiopathic autoimmune hemolytic anemia.
The majority of AUTO associated with ALLO appears to be due to RBC transfusion that must be recognized as a major cause for autoimmunization.
红细胞（RBC）自身抗体（AUTO）常与同种抗体（ALLO）相关。这些抗体共存的机制尚不清楚。
1998年8月至2006年6月期间，柏林夏里特大学医院所有检测到AUTO的门诊和住院患者均纳入本研究。采用检测RBC抗体的标准技术进行血清学检查。
共发现717例患者存在AUTO，其中200例（28%）患者同时存在ALLO。200例患者中有98例可评估抗体产生史。AUTO和ALLO均由RBC输血引起的有73例（75%），由外周血祖细胞移植引起的有6例（6%）。9例（9%）患者最初为同种免疫，随后出现AUTO。其余10例（10%）患者最初为自身免疫，后来出现ALLO。这些患者中只有6例患有慢性特发性自身免疫性溶血性贫血。
与ALLO相关的大多数AUTO似乎是由于RBC输血所致，必须将其视为自身免疫的主要原因。
