11-Oxycorticosteroid-Dependent Antibody in the Serum of a Patient with Bladder Neoplasm

Abstract

An IgM 11-oxycorticosteroid-dependent antibody was identified in the serum of a patient with bladder malignancy, which at 4-37 °C reacted with all the 11-oxycorticosteroids tested but not with desoxycorticosterone, testosterone, nortestosterone and progesterone. The resulting drug-antidrug antibody complex combines nonspecifically with red blood cells causing agglutination. This reactivity is enhanced both by acid pH and by high drug solution concentrations as well as by ficin test. The antibody is complement-independent and has no blood group specificity. No in vivo or in vitro hemolysis was observed.

In vitro reactions with red blood cells that are not due to blood group antibodies: a review

“…Other similar examples have been described. [11][12][13][14][15] Pinto and Rimon 16 showed that 26 percent of healthy adults had IgM antibodies to hydrocortisone in their sera; antibodies were rarely found in children less than 3 years of age.An interesting finding was that 80 percent and 100 percent of patients with syphilis and rheumatoid arthritis, respectively, had antibodies to steroids in their sera. 16 Hydrocortisone antibodies agglutinate RBCs suspended in hydrocortisone-containing media.…”