A case of chronic cold haemagglutinin disease due to an IgM monoclonal
(kappa) autoantibody with anti-M-like specificity is described in a patient with the MN
phenotype. The autoantibody was present in very high titre and active at body temperature,
but haemolysis was only mild. The direct antiglobulin test was positive due to C(3)d on the
patient’s red cells, and the autoantibody was able to bind complement to normal MM and
MN cells with a marked dosage effect.
The occurrence of post-transfusion purpura (PTP) in a 16-year-old girl with sickle/ß-thalassaemia is
described. Clinically this was a typical case of PTP, but it was unusual serologically. Anti-Bak^a and anti-Pl^A2
platelet-specific antibodies were identified and the patient’s platelets were typed as homozygous Pl^A1 -positive and
Bak^a-negative. The patient also developed red-cell, granulocyte and lymphocytotoxic antibodies in response to the
blood transfusion and had a delayed haemolytic transfusion reaction.
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