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基德抗体的事实与谬误:印度北部一家三级护理医院的经验

Facts and Fallacies of Kidd Antibodies: Experience in a Tertiary Care Hospital in North India.

作者信息

Makroo R N, Nayak Sweta, Chowdhry Mohit, Karna Prashant

机构信息

Department of Transfusion Medicine, Indraprastha Apollo Hospitals, Sarita vihar, New Delhi, 110076 India.

Immucor, Norcross, GA USA.

出版信息

Indian J Hematol Blood Transfus. 2017 Jun;33(2):254-258. doi: 10.1007/s12288-016-0678-7. Epub 2016 May 4.

Abstract

We have analyzed the method used in our laboratory to detect the most elusive, clinically significant alloantibody: the Kidd alloantibodies and find the most convenient procedure. A retrospective analysis of the method used in our laboratory for determining Kidd alloantibodies from January 2013 to May 2015 was conducted. The details of the event that sensitized the patient for red cell antibody formation and procedure used to detect the alloantibody were retrieved from the departmental records. Of 405 red cell antibody identification cases, 24 (5.9 %) had Kidd antibody (anti-Jka in 12: 50 % cases; anti-Jkb in 4: 16.7 % cases; multiple antibodies in 8: 32 % cases). Thirteen of 24 patients (54.2 %) had autocontrol positive of which 6 cases needed adsorption procedures whereas antibody/ies could be identified without adsorption procedure in the remaining 7 cases. All the 7 cases had autocontrol of 1+ strength. Of the 11 patients (45.8 %) with autocontrol negative, the antibody was identified using solid phase in 7 cases whereas tube panels were also used in the remaining 4 cases. Kidd alloantibodies though deceptive can be identified by sensitive techniques like the solid phase and simple but laborious techniques using the tube cell panels. Depending upon the reaction strength of the autocontrol, the routine autoadsorption process may be skipped and tube cell enzyme treated cells or solid phase techniques be used to get the results.

摘要

我们分析了本实验室用于检测最难捉摸且具有临床意义的同种抗体——基德同种抗体的方法,并找到了最便捷的程序。对本实验室2013年1月至2015年5月期间用于检测基德同种抗体的方法进行了回顾性分析。从科室记录中检索了使患者致敏形成红细胞抗体的事件细节以及用于检测同种抗体的程序。在405例红细胞抗体鉴定病例中,24例(5.9%)有基德抗体(12例为抗Jka,占50%;4例为抗Jkb,占16.7%;8例为多种抗体,占32%)。24例患者中有13例(54.2%)自身对照阳性,其中6例需要吸附程序,而其余7例无需吸附程序即可鉴定出抗体。所有7例自身对照强度均为1+。在11例(45.8%)自身对照阴性的患者中,7例使用固相法鉴定出抗体,其余4例还使用了试管细胞板。基德同种抗体虽然具有欺骗性,但可通过固相等敏感技术以及使用试管细胞板的简单但费力的技术来鉴定。根据自身对照的反应强度,可跳过常规的自身吸附过程,使用试管细胞酶处理细胞或固相技术来获得结果。

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