抗IH：一种值得一提的抗体。
Anti IH: An antibody worth mention.
作者信息
Mohanan Nithya, Henry Nittin, Rafi Aboobacker Mohamed, Innah Susheela J
机构信息
Department of Transfusion Medicine, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India.
出版信息
Asian J Transfus Sci. 2016 Jul-Dec;10(2):152-4. doi: 10.4103/0973-6247.187941.
A 72-year-old female with co-morbidities posted for surgical correction of fracture neck of femur without any history of transfusions was noted to have a hemoglobin level of 7 g/dl and packed red blood cells transfusion was ordered. Pretransfusion tests demonstrated A1B group with D positive on forward grouping. Reverse grouping showed a varying grade of agglutination with A, B, and O cells. Agglutination being stronger at 4°C. Antibody screening showed pan-agglutination, direct Coomb's test and auto control were negative. The serum reacted with adult O cells (OIadult) but not with adult Bombay cells (Oh Iadult) or O cord (Oicord) cells. A possibility of a compound cold antibody anti IH was made and A1B compatible cells were transfused to the patient. This case report illustrates anti-IH cold agglutinin with broad thermal amplitude. Uniqueness of this case report was O group incompatibility with A1B group, which was detected earlier and a catastrophic transfusion reaction being subverted.
一名72岁患有多种合并症的女性患者，拟行股骨颈骨折手术矫正，既往无输血史，血红蛋白水平为7 g/dl，遂医嘱输注浓缩红细胞。输血前检查显示正向定型为A1B型、D抗原阳性。反向定型显示与A、B和O细胞有不同程度的凝集，4°C时凝集更强。抗体筛查显示全凝集，直接抗人球蛋白试验及自身对照均为阴性。血清与成人O细胞（OIadult）发生反应，但不与成人孟买细胞（Oh Iadult）或O脐血（Oicord）细胞发生反应。考虑存在复合冷抗体抗IH的可能性，遂给患者输注了与A1B相容的细胞。本病例报告说明了具有广泛热幅度的抗IH冷凝集素。本病例报告的独特之处在于较早发现O型与A1B型不相容，并避免了严重的输血反应。
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