Gayathri A M, Gupta Debasish
Department of Transfusion Medicine, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India.
Asian J Transfus Sci. 2020 Jan-Jun;14(1):54-56. doi: 10.4103/ajts.AJTS_60_19. Epub 2020 Jul 24.
Anti-Lewis antibodies, usually do not react at 37°C, hence are clinically insignificant. However, on rare occasions, these antibodies have been reported as the cause for hemolytic transfusion reaction (HTR).
We report our experience on the 6 cases of anti-Lewis antibodies that reacted at room temperature (RT) and at 37°C.
Standard serological methods were employed in detection and identification of antibodies. Demographic and clinical details were obtained from the records on the subjects under study.
These were found among the patients and the blood donors of varied age groups and gender (21 to 65 years). Also, they were found among the patients with varied clinical diagnosis. The 2 patients in second trimester had anti-Le a or anti-Le b and other 2 male patients had anti-Le ab or anti-Le b with wide thermal amplitude were found during the course of pre- transfusion compatibility tests including antibody screening and cross-matching. Two male donors typed Le (a-b-) had anti-Le ab with wide thermal amplitude. Lewis antigen negative RBC units were provided for transfusion in the situation.
Although antibodies to Lewis blood group antigens often react at lower temperatures and therefore remain clinically insignificant, some of them, on rare circumstances, may react at higher temperature of 37°C and may produce hemolytic episode or at least yield reduce survival of incompatible red cells in transfusion recipients. On safer side, the antigen-negative unit may be used in transfusion. The donors' registry with detailed phenotype profile may go a long way to provide blood for transfusion in emergency situations.
抗刘易斯抗体通常在37°C时不发生反应，因此在临床上无显著意义。然而，在极少数情况下，这些抗体被报道为溶血性输血反应（HTR）的病因。
我们报告6例在室温（RT）和37°C时发生反应的抗刘易斯抗体的经验。
采用标准血清学方法检测和鉴定抗体。从研究对象的记录中获取人口统计学和临床详细信息。
这些抗体在不同年龄组和性别的患者及献血者中均有发现（21至65岁）。此外，在临床诊断各异的患者中也有发现。在包括抗体筛查和交叉配血在内的输血前相容性检测过程中，发现2例孕中期女性患者有抗-Lea或抗-Leb，另外2例男性患者有抗-Leb或抗-Leb且热振幅较宽。2例血型为Le（a-b-）的男性献血者有热振幅较宽的抗-Leb。在此情况下，提供Lewis抗原阴性的红细胞单位用于输血。
尽管针对刘易斯血型抗原的抗体通常在较低温度下发生反应，因此在临床上无显著意义，但在极少数情况下，其中一些抗体可能在37°C的较高温度下发生反应，并可能导致溶血事件，或至少使输血受者中不相容红细胞的存活率降低。为安全起见，输血时可使用抗原阴性的单位。具有详细表型特征的献血者登记册在紧急情况下为输血提供血液方面可能会有很大帮助。
