Application du gel test utilisant une antiglobuline anti-IgA au diagnostic immunologique d'anémie hémolytique auto-immune à test de Coombs direct négatif

Meyer, Francis; Garin, L.; Smati, C.; Gaspard, M; Giannoli, C.; Rigal, Dominique

doi:10.1016/s1246-7820(99)80032-9

Cited by 18 publications

(6 citation statements)

References 9 publications

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“…Production of warm reactive autoantibodies, IgG, IgM, and IgA that target the body's own red blood cells (RBC) is the main cause of warm autoimmune hemolytic anemia (WAIHA) [5, 6]. The etiology underlying the pathogenesis of such autoantibodies is still unclear.…”

Section: Elucidation Of Mechanism Of Waiha Contributes To Developimentioning

confidence: 99%

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Immunotherapy Treatments of Warm Autoimmune Hemolytic Anemia

Liu

2013

Clinical and Developmental Immunology

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Warm autoimmune hemolytic anemia (WAIHA) is one of four clinical types of autoimmune hemolytic anemia (AIHA), with the characteristics of autoantibodies maximally active at body temperature. It produces a variable anemia—sometimes mild and sometimes severe. With respect to the absence or presence of an underlying condition, WAIHA is either idiopathic (primary) or secondary, which determines the treatment strategies in practice. Conventional treatments include immune suppression with corticosteroids and, in some cases, splenectomy. In recent years, the number of clinical studies with monoclonal antibodies and immunosuppressants in the treatment of WAIHA increased as the knowledge of autoimmunity mechanisms extended. This thread of developing new tools of treating WAIHA is well exemplified with the success in using anti-CD20 monoclonal antibody, Rituximab. Following this success, other treatment methods based on the immune mechanisms of WAIHA have emerged. We reviewed these newly developed immunotherapy treatments here in order to provide the clinicians with more options in selecting the best therapy for patients with WAIHA, hoping to stimulate researchers to find more novel immunotherapy strategies.

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Section: Elucidation Of Mechanism Of Waiha Contributes To Developimentioning

confidence: 99%

“…WAIHA can be caused by a number of different classes of antibody, with IgG, and IgM antibodies being the main causative classes. IgA class antibodies are present in approximately 14% of patients with WAIHA and are almost always associated with IgG or IgM [5, 6]. If no underlying causes can be identified in WAIHA, it is truly primary.…”

Section: Introductionmentioning

confidence: 99%

Immunotherapy Treatments of Warm Autoimmune Hemolytic Anemia

Liu

2013

Clinical and Developmental Immunology

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“…The autoantibodies can arise spontaneously or in the setting of a condition or medication and are typically IgG [ 2 ]. Up to 14% of patients with WAIHA can have IgA autoantibodies, but these are commonly detected alongside IgG or IgM [ 3 , 4 ]. WAIHA, associated exclusively with IgA antibodies, remains rare [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…IgA-mediated WAIHA can present with severe hemolytic anemia and a negative DAT [ 8 ]. Steroids with or without rituximab are the mainstay of treatment [ 4 , 7 ]. Early detection using an extended DAT panel with monospecific antisera helps in avoiding further investigations and provides efficient management.…”

Section: Introductionmentioning

confidence: 99%

A Case of Coombs-Negative Primary Warm Autoimmune Hemolytic Anemia Due to IgA Antibody That Responded Well to Rituximab and Steroids

Gergal Gopalkrishna Rao

2024

Cureus

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Warm autoimmune hemolytic anemia (WAIHA) occurs due to antibodies active at body temperature that react with antigens on the surface of red blood cells, leading to hemolysis. Antibodies are typically IgG. WAIHA, associated exclusively with IgA antibodies, remains rare. Direct antiglobulin (Coombs) test may result negative in IgA antibody associated WAIHA. IgA-mediated WAIHA can present with severe hemolytic anemia. Further testing using an expanded direct antiglobulin test (DAT) panel is necessary to detect IgA antibodies if there is a high suspicion of autoimmune hemolytic anemia in cases that initially test negative for DAT. Steroids with or without rituximab are the mainstay of treatment. Early detection using an extended DAT panel with monospecific antisera helps avoid further investigations, unnecessary transfusions, and complications.

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“…20 Previous investigators have demonstrated IgG and IgA autoantibodies on RBCs with more sensitive methods than the DAT in patients with a DAT-negative AIHA. [21][22][23][24][25] The patients were diagnosed by clinical manifestations including the exclusion of other hemolytic disorders and a positive clinical course following administration of corticosteroid. These results showed that the quantitative determination of immunoglobulins on eluates by ELISA appears to be useful for the serologic diagnosis of DATnegative AIHA, although the assay should be evaluated with a larger number of cases.…”

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confidence: 99%

Quantitation of red cell–bound IgG, IgA, and IgM in patients with autoimmune hemolytic anemia and blood donors by enzyme-linked immunosorbent assay

Bencomo

Diaz²,

Alfonso³

et al. 2003

Immunohematology

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This paper describes an enzyme immunoassay for the quantitative determination of IgG, IgA, and IgM immunoglobulins on RBCs. Ether eluates made from RBCs were followed by an enzyme-linked immunosorbent assay of immunoglobulin concentration. Calibration curves were derived from immunoglobulin standards and the number of molecules of each isotype per RBC was calculated. The assay was carried out in 200 healthy blood donors and 62 patients with warm autoimmune hemolytic anemia (AIHA), two of them with a negative DAT. For healthy blood donors, mean values were 58 IgG, 16 IgA, and 3 IgM molecules per RBC. For patients with a positive DAT, the mean values were 3435 IgG, 157 IgA, and 69 IgM molecules per RBC. An increased level of IgA was found in 12 patients without IgA autoantibodies demonstrable in RBC eluates. Increased IgG levels were also observed in patients with a negative DAT and, in one case, an increased level of IgA was also found. The enzyme-linked immunosorbent assay using ether eluates is a sensitive method for quantitating RBC autoantibodies in patients with AIHA as well as immunoglobulins bound to RBCs in healthy individuals.

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Application du gel test utilisant une antiglobuline anti-IgA au diagnostic immunologique d'anémie hémolytique auto-immune à test de Coombs direct négatif

Cited by 18 publications

References 9 publications

Immunotherapy Treatments of Warm Autoimmune Hemolytic Anemia

Immunotherapy Treatments of Warm Autoimmune Hemolytic Anemia

A Case of Coombs-Negative Primary Warm Autoimmune Hemolytic Anemia Due to IgA Antibody That Responded Well to Rituximab and Steroids

Quantitation of red cell–bound IgG, IgA, and IgM in patients with autoimmune hemolytic anemia and blood donors by enzyme-linked immunosorbent assay

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