A multilaboratory investigation during several years has identified a low incidence antigen JAL on the red cells of 7 propositi. JAL appears to be associated with two unusual Rh complexes, one of which produces a depressed C antigen and the other a depressed c antigen. Family studies strongly suggest that the JAL antigen is encoded by the RH locus. Anti-JAL has been implicated in haemolytic disease of the newborn and is thus considered to be a clinically significant antibody.
The Lui elution and the heat elution techniques are the most simple techniques available for eluting antibodies from red cells. Both are very effective for eluting ABO antibodies. We compared the two techniques and found the Lui technique superior in that it more efficiently eluted ABO antibodies, required less hands-on time, and allowed more flexibility in the procedure. We therefore recommend the Lui elution technique as the method of choice for eluting ABO antibodies, especially for the evaluation of hemolytic disease of the newborn.
A 56-year-old woman was admitted to the hospital for severe anemia. She was diagnosed as having mixed connective tissue disease (MCTD) 6 years ago. On admission, her WBC count was 9.9 × × × × 10 3 /μ μ μ μL, her Hb level was 6 g per dL, and her Hct level was 17 percent by the microhematocrit method. The Hct level could not be measured by the Beckman-Coulter hematology system owing to aggregation of RBCs (Panel A, arrows; peripheral blood smear, Wright's stain [100× × × ×]). Her serum haptoglobin level was less than 6.0 mg per dL (normal, 30-195 mg/dL); serum LDH, 478 U per L (normal, < < < <240 U/ L); total serum bilirubin, 2.8 mg per dL (normal, < < < <1.3 mg/dL); and direct bilirubin, 0.4 mg per dL (normal, 0-0.3 mg/ dL). The reticulocyte count was 10.4 percent. The patient's RBCs were positive by DAT. The reactivity was 3+ + + + with both monospecific anti-IgG and anti-C3b/C3d, respectively. The serum reacted 3+ + + + with all panel cells tested only at the antihuman globulin phase (AHG) with LISS as the enhancement medium. The serum sample, however, also reacted with ficinized screen cells, 4+ + + + at immediate spin, 3+ + + + at 37°°°°C, and 4+ + + + at AHG phases. No alloantibody was detected in her serum sample and the patient gave no history of blood transfusion.Panel A shows RBC aggregates (arrows) and amorphous purple material of unknown origin, which may represent abnormal protein (arrowheads). Direct immunofluorescent stains of the peripheral blood smear fixed in cold acetone
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