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埃及依赖输血的地中海贫血患者的红细胞同种免疫与自身抗体。

Red cell alloimmunization and autoantibodies in Egyptian transfusion-dependent thalassaemia patients.

机构信息

Department of Paediatrics, National Research Centre, Cairo, Egypt.

出版信息

Arch Med Sci. 2010 Aug 30;6(4):592-8. doi: 10.5114/aoms.2010.14473. Epub 2010 Sep 7.

Abstract

INTRODUCTION

The objective of this study was to explore the frequency of red cell alloantibodies and autoantibodies among β-thalassaemia patients who received regular transfusions.

MATERIAL AND METHODS

This study included 501 patients with β-thalassaemia. This work planned to study the presence of alloantibodies and autoantibodies to different red cell antigens in multitransfused thalassaemia patients using the ID. Card micro typing system.

RESULTS

Of a total of 501 β-thalassaemia patients included in the study, 11.3% of patients developed alloantibodies; 9.7% of these alloantibodies were clinically significant. The most common alloantibodies were anti-K, anti-E and anti-C. The rate of incidence of these alloantibodies was 3.9%, 3.3% and 1.7% respectively. Autoantibodies occurred in 28.8% of the patients and 22.1% of these antibodies were typed IgG. There was a significant association between splenectomy with alloimmunization and autoantibody formation (p = 0.03, p = 0.001 respectively). There was no significant association between alloantibody, autoantibody formation and number of transfused packed red cells.

CONCLUSIONS

Alloimmunization to minor erythrocyte antigens and erythrocyte autoantibodies of variable clinical significance are frequent findings in transfused β-thalassaemia patients. There is an association between absence of the spleen and the presence of alloimmunization and autoantibody formation.

摘要

简介

本研究的目的是探讨接受定期输血的β-地中海贫血患者中红细胞同种抗体和自身抗体的频率。

材料和方法

本研究纳入了 501 例β-地中海贫血患者。本研究计划使用 ID.Card 微柱血型鉴定系统研究多次输血的地中海贫血患者中不同红细胞抗原的同种抗体和自身抗体的存在情况。

结果

在纳入研究的 501 例β-地中海贫血患者中,11.3%的患者产生了同种抗体;其中 9.7%的同种抗体具有临床意义。最常见的同种抗体是抗-K、抗-E 和抗-C,其发生率分别为 3.9%、3.3%和 1.7%。28.8%的患者发生自身抗体,其中 22.1%的自身抗体为 IgG 型。脾切除术与同种免疫和自身抗体形成之间存在显著相关性(p=0.03,p=0.001)。同种抗体、自身抗体形成与输注的浓缩红细胞数量之间无显著相关性。

结论

在接受输血的β-地中海贫血患者中,经常发现对小红细胞抗原的同种免疫和具有不同临床意义的红细胞自身抗体。脾切除与同种免疫和自身抗体形成之间存在相关性。

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