Kakaiya R M, Sherman L A, Miller W V, Katz A J
Ann Clin Lab Sci. 1981 Nov-Dec;11(6):511-5.
The association of autoimmune thrombocytopenia and autoimmune hemolytic anemia (Evans Syndrome) has been recognized previously. Recently the present authors investigated a patient with this disorder. Both IgG and C3d were found on the patient's red cells and the serum contained a polyspecific IgG red cell antibody demonstrable only by the antiglobulin test. IgG antiplatelet antibody was demonstrated on circulating platelets as well as in the serum from the patient by using 125I-staphylococcal Protein A (ISPA) assay. Absorption of serum with normal platelets resulted in removal of platelet antibody, but not the red cell antibody. Furthermore, eluate prepared from platelets sensitized with patient serum contained an IgG antibody directed specifically against platelets, since it did not cross react with red cells. Our data suggest the presence of two distinct antibodies, one directed against platelets and the other against red cells in our patient with Evans Syndrome. Both these antibodies are IgG in nature and belong to subclass other than IgG3 since staphylococcal Protein A (SPA) binds to all subclasses of human IgG except IgG3.
自身免疫性血小板减少症与自身免疫性溶血性贫血（伊文斯综合征）的关联此前已得到认可。最近，本文作者对一名患有该疾病的患者进行了研究。在患者的红细胞上发现了IgG和C3d，并且血清中含有仅通过抗球蛋白试验可证实的多特异性IgG红细胞抗体。通过使用125I-葡萄球菌蛋白A（ISPA）测定法，在循环血小板以及患者的血清中均证实了IgG抗血小板抗体。用正常血小板吸收血清可导致血小板抗体被清除，但红细胞抗体未被清除。此外，由患者血清致敏的血小板制备的洗脱液中含有一种特异性针对血小板的IgG抗体，因为它不与红细胞发生交叉反应。我们的数据表明，在我们患有伊文斯综合征的患者中存在两种不同的抗体，一种针对血小板，另一种针对红细胞。这两种抗体本质上均为IgG，且属于除IgG3以外的亚类，因为葡萄球菌蛋白A（SPA）可与人类IgG的所有亚类结合，除了IgG3。
