A 31-yr-old woman with a 12 yr history of relapsing idiopathic autoimmune haemolytic anaemia was studied prospectively during her first pregnancy. Her serum contained a warm incomplete autoantibody as well as an elevated cold agglutinin; her red blood cells were strongly coated with IgG and complement (chiefly a2D). Haemolysis was active throughout pregnancy, accelerating from the 34th to 40th week, with developing thrombocytopenia. Amniocentesis in the 8th and 9th months suggested minimal foetal haemolysis. The maternal haemolytic process went into complete clinical remission following delivery of a healthy appearing infant whose red cells were coated with IgG. The infant developed mild hyperbilirubinaemia within 48 hr and experienced a fall in haemoglobin to 50% of the cord level by the 8th week. Abnormalities of maternal and infant C4 levels were observed. Review of 19 reported instances of presumed autoimmune haemolysis during pregnancy revealed life-threatening anaemia in nearly 50% of mothers, with four still-births, one neonatal death, and three seriously affected infants. A programme for prospective management of this serious clinical problem is discussed.Acquired autoimmune haemolytic anaemia (AIHA) is not a rare haematologic disorder; 20-30 patients with this illness are treated annually at the Washington University Medical Center. Approximately 30% of our cases are 'idiopathic'; of these, one-fourth occur in women in the child-bearing second to fifth decades (Allgood& Chaplin, 1967). It is surprising, therefore, that a search of the literature for the past 50 years reveals only 19 reports of pregnancy in patients with presumed AIHA. Among these, seven mothers exhibited a positive direct antiglobulin test; two of these delivered stillborn infants at 6 months gestation, a third infant developed severe anaemia requiring transfusions at 2 mth of age. In none of the reports were the serological findings in mothers and infants characterized in detail or followed in a systematic sequential manner.Recently, a 31-yr-old patient who had been followed by one of the authors (H.C.) for
Red blood cells of a type B patient became polyagglutinable eight years ago and have remained so to the present. No infection or other cause for the phenomenon has been diacovered and laboratory studies have established conclusively that the polyagglutinability is distinguishable from Tantigen activation and Irom the effect of periodate treatment in vitro. Cambind 51Cr and Ashby di&rcntial agglutination studies of the survival in Vivo of normal type B donor blood demonstrated that the transfused cells did not become polyag glutinable during more than four months in the patient's circulation. I t is concluded that the underlying abnormality of the patient's red blood cella originates during their formative stage in the bone marrow. The clinical implications of these findings and their possible relationship to the patient's accompanying leukopenia and thrombocytopenia are discussed briefly. POLYACCLUTINABILITY of human red blood cells; i.e., the condition in which the individual's red blood cells are agglutinated by the majority of normal and ABO compatible human sera, can create difficulties in blood typing and testing for compatibility. T h e clinical implications of polyagglutinability and its associated laboratory problems could be dealt with more
The use of fresh frozen plasma (FFP) often results in unused thawed units because of the time required to thaw FFP prior to use. A rapid thawing technique was studied, utilizing a microwave oven. Resultant levels of coagulation factors were compared with conventional slow thawing in a 37 C water bath. Mean prefreezing, rapid thaw and conventional thaw values were fibrinogen 246, 223, 238 mg/100 ml; prothrombin 101, 103, 105 per cent; factor V; 102, 79, 86 per cent; factor VIII 94, 77, 75 per cent; factor IX 103, 92, 90 per cent; factors VII/X 101, 107, 103 per cent; and factor × 84, 79, 82 per cent. No significant differences existed between rapid thawing and conventional thawing for any coagulation factor studied. Average thawing times were five minutes for rapid thawing (RT) and 25 minutes for conventional thawing. Although careful establishment of thawing time is required for each oven, microwave thawing permits better utilization of FFP for surgery and speeds delivery in emergencies, without destroying coagulation proteins.
Mycoplasmas are useful models for biochemical studies of the mechanism of complement-mediated killing by antibodies to various membrane components. The purpose of this study was to determine the membrane antigens involved in immune killing of Acholeplasma laidlawii. Antibodies to A. laidlawii membrane total lipids, glycolipids, and phospholipids could be induced in rabbits after injection of reaggregates of the purified lipids with Mycoplasma hominis protein as the carrier. Killing of A. laidlawii membrane lipids were less effective than anti-membrane protein antisera in killing the organisms. Of the antisera to lipid components of A. laidlawii membranes, antiserum to phospholipids showed a more pronounced killing effect than antiserum to glycolipids. The antibodies to A. laidlawii in the rabbit antisera belong predominantly to the immunoglobulin G class of immunoglobulins. Double-diffusion tests in agar indicated that two immunologically reactive proteins are located on the membrane surface.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.