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[新生儿溶血病合并罕见抗-LW抗体自身免疫性溶血性贫血患者的输血策略]

[Transfusion Strategy for Rare Anti-LW Antibody Autoimmune Hemolytic Anemia Patients with Neonatal Hemolytic Disease].

作者信息

Tian Dong-Dong, Zhao Ding, Li Zhi-Hao, Li Wei, Yang Jia-Li, Zhang Xiao-Pan, Zheng Liu-Chuang

机构信息

Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou 450018, Henan Province, China.

Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou 450018, Henan Province, China,E-mail:

出版信息

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2021 Dec;29(6):1935-1939. doi: 10.19746/j.cnki.issn.1009-2137.2021.06.042.

DOI:10.19746/j.cnki.issn.1009-2137.2021.06.042
PMID:34893137
Abstract

OBJECTIVE

To analyze the causes of positive irregular antibody screening test and incompatibility of cross matching in one patient with autoimmune hemolytic anemia complicated with neonatal hemolytic disease, and to accurately identify the type of antibodies in patients, and to select a reasonable strategy for blood transfusion.

METHODS

One children was enrolled, blood group positive and reverse typing, Rh typing, direct anti-human globulin test, free test, dispersal test and cross matching test were carried out by test tube method and microcolumn gel card; irregular antibodies were identified by the reaction of DTT treatment and untreated panel cells with patients' plasma.

RESULTS

The blood group of the patient was RhD positive B and irregular antibody screening positive, while the blood group of the mother was RhD positive O and irregular anti-screening negative, the result showed that the anti-LW detected in the plasma of the patient was autoantibody and ABO neonatal hemolytic disease (ABO-HDN) was present. Both O type RhD positive washing RBCs and B type RhD negative RBCs were transfused effectively.

CONCLUSION

Irregular antibodies in patients are anti-LW antibodies, and transfusion of homotype RhD negative suspended erythrocytes after the exclusion of ABO-HDN shows a better effect.

摘要

目的

分析1例自身免疫性溶血性贫血合并新生儿溶血病患者不规则抗体筛查阳性及交叉配血不相合的原因,准确鉴定患者抗体类型,选择合理的输血策略。

方法

纳入1例患儿,采用试管法和微柱凝胶卡法进行血型正反向定型、Rh定型、直接抗人球蛋白试验、游离试验、放散试验及交叉配血试验;通过二硫苏糖醇(DTT)处理和未处理的谱细胞与患者血浆反应鉴定不规则抗体。

结果

患者血型为RhD阳性B型,不规则抗体筛查阳性,其母血型为RhD阳性O型,不规则抗体筛查阴性,结果显示患者血浆中检测到的抗-LW为自身抗体,存在ABO新生儿溶血病(ABO-HDN)。输注O型RhD阳性洗涤红细胞和B型RhD阴性红细胞均有效。

结论

患者不规则抗体为抗-LW抗体,排除ABO-HDN后输注同型RhD阴性悬浮红细胞效果较好。

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Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2021 Dec;29(6):1935-1939. doi: 10.19746/j.cnki.issn.1009-2137.2021.06.042.
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