Vengelen-Tyler V, Mogck N
Reference Services Laboratory, American Red Cross Blood Services, Los Angeles-Orange Counties Region, California.
Transfusion. 1991 Mar-Apr;31(3):254-6. doi: 10.1046/j.1537-2995.1991.31391165176.x.
Two cases are described in which autoantibodies mimicked alloantibodies. The direct antiglobulin test (DAT) on the red cells (RBCs) from both patients was negative when routine manual hexadimethrine bromide (Polybrene) and enzyme-linked antiglobulin techniques were used. The RBCs also did not react on direct bromelin and direct Polybrene tests. However, an "hrB-like" antibody was eluted from the RBCs of both patients. The sera from these patients reacted with all e+ hrB+ RBCs but not with e+ hrB-, e-, or their own RBCs. The antibody in the serum of one patient was not adsorbed by R2R2 RBCs. Serologic tests initially suggested (by direct testing and adsorption studies) that the serum antibodies were alloantibodies rather than autoantibodies. RBCs taken from one patient, 8 months after her sample was first referred to our laboratory, reacted with a serum sample from her first admission. An RBC sample taken from the other patient, initially typed e+ and hrB- but 1 month later typed e+ and hrB+ by using the same anti-hrB sera, was used to test the earlier samples.
本文描述了两例自身抗体模拟同种抗体的病例。当使用常规手工聚凝胺（鱼精蛋白）和酶联抗球蛋白技术时，两名患者红细胞（RBC）的直接抗球蛋白试验（DAT）均为阴性。红细胞在直接菠萝蛋白酶试验和直接聚凝胺试验中也无反应。然而，从两名患者的红细胞中洗脱出来一种“类hrB”抗体。这些患者的血清与所有e+hrB+红细胞发生反应，但不与e+hrB-、e-红细胞或其自身红细胞发生反应。其中一名患者血清中的抗体不能被R2R2红细胞吸附。血清学检测最初（通过直接检测和吸附研究）提示血清抗体是同种抗体而非自身抗体。从一名患者首次向我们实验室送检样本8个月后采集的红细胞，与她首次入院时的一份血清样本发生反应。从另一名患者采集的红细胞样本，最初分型为e+和hrB-，但1个月后使用相同的抗hrB血清分型为e+和hrB+，用其检测早期样本。
