The resolution of the ABO discrepancy is essential to prevent transfusion reactions due to ABO incompatibility, which gives us a type of severe hemolytic reaction due to acute intravascular hemolysis and renal failure. This discrepancy occurs when the divergence between the forward and reverse typing of the patient. The aim of this study was to investigate the cause of the ABO discrepancy of a sample received at the Hemotherapy Service of the Hospital de Clínicas de Porto Alegre (HCPA) to perform an admission blood typing, and the ABO discrepancy found was: direct typing of A and reverse reaction with 2+ reaction on anti-A and 4+ on anti-B. To solve the case, serological phenotyping techniques were used with Lorne® antisera and Bio-Rad® gel card. Irregular antibody screening (PAI) and irregular antibody identification panel (IAI) were performed with a panel of red blood cells and a panel of red blood cells treated with proteolytic enzymes (papain) in liss/coombs gel from Bio-Rad® and used Dithiothreitol (DTT) for reverse red blood cell treatment. The investigation of the ABO subgroup with anti-H and anti A1 serum, it was concluded that the patient was typed A1, the performance of the PAI was positive with multiple antibodies.
Currently, ABO incompatibility has been a major cause of HPLD, where the mother's IgG antibodies, preferably those of blood group O, cross the placental barrier and attack fetal erythrocytes that contain A and/ or B antigens. direct) is a test used to assist in this diagnosis, however, elution has been shown to be a test with greater sensitivity to assist in cases of DHPN. The aim of this study was to evaluate and compare the sensitivity and positive predictive value of TAD and elution in diagnosing DHPN. Materials and methods: TAD and freeze elution (LUI) were performed on samples of newborns from group A or B with mother from group O. Results: The results of this study identified a maternal fetal mother O incompatibility with fetus A of 80.3% and mother O with fetus B of 19.7%. The frequency of jaundice and need for phototherapy in the neonatal population was equivalent in the groups with LUI+/TADand LUI+/TAD+ and the negative predictive value of the eluate is 1. Conclusion: With this evaluation, it will be possible to early identify a possible ABO incompatibility as a cause hemolysis or jaundice, allowing better and faster management for patients. Thus, we conclude that, potentially, the eluate is an exam with better accuracy, especially in the sensitivity of the test and with a negative predictive value of 100%.
Genetic polymorphisms in genes related to the metabolism of xenobiotics, how the genes of the glutathione S-transferases superfamily (GSTM1, GSTT1 and GSTP1) have been associated with an increased risk for breast cancer (BC). A literature review was performed using the database PubMed, verifying the frequency of GSTM1, GSTT1 and GSTP1 polymorphisms in studies associated with breast cancer in the last decade, including 27 studies, 14 verified the frequency of GSTM1 and GSTT1 null polymorphisms in women without cancer and 22 in women with cancer; and for the GSTP1 gene, 12 studies verified the genotypic frequency of GSTP1 A/G in women without breast cancer and 18 in women with breast cancer. The mean frequency of the GSTT1 and GSTM1 null genes found in studies with women without breast cancer was 28% and 45% and the mean allele frequencies of the GSTP1 gene for women without breast cancer was 57.7% for the Ile allele and 34% for the Val allele, and the mean frequency of the GSTT1 and GSTM1 null genes found in studies with women with breast cancer was 34.7% and 41.4% and the mean allele frequencies of the GSTP1 gene for women with breast cancer was 59.8% for the Ile allele and 40.2% for the Val allele. Therefore, considering the importance of these genes in carcinogen metabolism, together with the allelic and genotypic frequencies of the polymorphisms studied in this review that differ from one study to another, we suggest that other factors may influence this distribution.
the positivity of PAI for antibodies of clinical significance was verified. It is important to assess the cost-effectiveness of including this test as the technique detects a large proportion of antibodies without specificity and/or clinical relevance.
The phenomenon of transfusion-related immunomodulation (TRIM) has been studied since the observation of a higher kidney allograft survival in patients who had received a higher number of transfusions. Conversely, it has been suggested as one of the possible causes related to the development of infections in patients with multiple blood transfusions and/or after a major surgery, and has been also associated with a decreased function of natural killer cells (NK) and antigen-presenting cells (APCs), reduced cell-mediated immunity, and increased regulatory T cells (Tregs). This review aimed to conceptualize TRIM and discuss some aspects related to its mechanisms and the prevention of immunomodulatory events.
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