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真眼识破真谎言:免疫血液学中干扰性抗体的病例报告及综述

Real eyes realizes real lies: A case report and review of nuisance antibodies in immunohematology.

作者信息

Kandasamy Dhivya, Shastry Shamee, Chenna Deepika, Mohan Ganesh

机构信息

Department of Immunohematology and Blood Transfusion, Kasturba Medical College, Manipal Academy of Higher Educations, Manipal, Karnataka, India.

出版信息

Asian J Transfus Sci. 2018 Jul-Dec;12(2):169-172. doi: 10.4103/ajts.AJTS_100_17.

Abstract

Detection of nonspecific antibodies unrelated to blood group antigen that causes nuisance in pretransfusion testing is a rare event. Their interpretation is often made only after the exclusion of all possible clinically significant antibodies and results in the unnecessary expenditure of reagents and human resources. We report one such nuisance antibody detected in an antenatal female that showed pan reaction with antibody screening and identification panel red cells including auto control but was compatible with group-specific donor units. Direct antiglobulin test was positive with no hematological evidence of bleeding. Repeat antibody screening test performed after washing the panel red cells and use of panel cells from different manufacturer showed negative reaction raising the suspicion of antibody specificity against chemical constituents in suspension medium of panel cells. Interpretation of nonspecific antibodies as to what they really are demands extensive immunohematological work-up and causes a delay in issue of blood components to the recipient.

摘要

在输血前检测中,检测到与血型抗原无关的非特异性抗体并造成干扰是罕见事件。通常只有在排除所有可能具有临床意义的抗体后才对其进行解读,这会导致试剂和人力资源的不必要消耗。我们报告了在一名产前女性中检测到的一种此类干扰性抗体,该抗体在抗体筛查和鉴定板红细胞(包括自身对照)上呈现全凝集反应,但与血型特异性供体单位相匹配。直接抗球蛋白试验呈阳性,无出血的血液学证据。在用不同厂家的板红细胞洗涤并使用后进行的重复抗体筛查试验显示为阴性反应,这引发了对针对板红细胞悬浮介质中化学成分的抗体特异性的怀疑。对非特异性抗体的真正性质进行解读需要广泛的免疫血液学检查,并导致向受血者发放血液成分的延迟。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b1c/6327759/63c1a2b9c861/AJTS-12-169-g001.jpg

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