The human platelet alloantigens HPA-1, -2, -3, -5 and -6b in the Finnish population were determined using allele specific restriction analysis (PCR-ASRA) for HPA-1, -2, -3 and -5 and monoclonal antibody immobilized platelet antigen (MAIPA) assay for HPA-1, -3a, -5b and -6b. No discrepancies were observed between the results obtained with the PCR-method and those obtained serologically. The gene frequencies obtained from 200 unrelated Finns were 0.86 and 0.14 for HPA-1a and -1b, 0.91 and 0.09 for HPA-2a and -2b, 0.59 and 0.41 for HPA-3a and -3b and 0.95 and 0.05 for HPA-5a and -5b. The frequency of the HPA-5b allele (10%) is lower in Finns than in Central- or South-European populations (20-30%). The HPA-1, -2 and -3 frequencies did not deviate from those observed in other European populations. The rare HPA-6b antigen was observed in three of 127 individuals from south-eastern Finland (2.4%), which suggests that the frequency of this allele in Finland is higher than previously thought.
Circulating immune complexes (CICs), immunoconglutinins, and antiglobulins were studied in nephropathia epidemica, an acute infectious hemorrhagic fever occurring in Finland and Scandinavia. Sixty-one serum specimens from 18 serologically confirmed patients were collected between day -5 and day 230 from the onset of fever. Five CIC tests, three immunoconglutinin tests, and various other tests were used to characterize the disease immunologically. CICs were found in all patients. The percentage detection of positive cases varied in the tests from 100% to 22%. A marked stimulation of levels of the IgM class of immunoglobulins were observed. Antiglobulin tests were positive for all of the patients. No correlation between the test results and the clinical severity of the disease could be found. Of special interest was the delay in the rise of CIC levels compared with the chromologic pattern of the clinical course. In some patients a prolonged appearance of CICs for eight months was observed.
The ability to detect and to identify platelet-specific alloantibodies varied widely between laboratories and between various examples of antibodies issued. An increase in the number of laboratories screening for HPA-15 antibodies was seen, although detection and identification of these antibodies was problematic. The majority of examples of HPA-3a antibodies and some examples of HPA-1a and -5b were also difficult to detect and identify. In addition, this scheme has shown that despite the apparent reliability of molecular typing techniques, mistakes do occur, particularly with certain systems. Approximately one in five laboratories participating in the serology exercises and one in seven participating in the genotyping exercises were classified as poor performer at one point or more during the series of exercises.
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