Evaluation of the manual hexadimethrine bromide (Polybrene) technique in the investigation of autoimmune hemolytic anemia

Owen, Irene; Hows, Jill

doi:10.1046/j.1537-2995.1990.30991048787.x

Cited by 11 publications

(4 citation statements)

References 7 publications

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“…7 . Embora as amostras de sangue para este estudo tenham sido coletadas em alguns pacientes na vigência de tratamento específico, o que poderia ter contribuído para a queda do título do auto-anticorpo, para um mesmo título de autoanticorpo em determinado paciente o TPD foi mais sensível que o TCD na detecção de sensibilização eritrocitária.…”

Section: Resultsunclassified

Diagnóstico laboratorial da anemia hemolítica auto-imune: características do teste manual direto do Polybrene<FONT FACE=Symbol>Ò</FONT>

Braga¹,

Bordin²,

MOREIRA³

et al. 1998

Rev. Assoc. Med. Bras.

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Section: Resultsunclassified

Diagnóstico laboratorial da anemia hemolítica auto-imune: características do teste manual direto do Polybrene<FONT FACE=Symbol>Ò</FONT>

Braga¹,

Bordin²,

MOREIRA³

et al. 1998

Rev. Assoc. Med. Bras.

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“…1,6,23 Others have also found this test to be useful for DAT-negative AIHA samples. 8,24 We had limited hematologic data and follow-up of the patients in this study. The data reflect the results of tests on samples from patients who were suspected to have AIHA but the hospital laboratory had reported a negative DAT.…”

Section: Discussionmentioning

confidence: 99%

Attempts to support an immune etiology in 800 patients with direct antiglobulin test–negative hemolytic anemia

Leger

Hunt

2010

Immunohematology

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Clinical and hematologic evidence of warm autoimmune hemolytic anemia (AIHA) is present in some patients whose direct antiglobulin test (DAT) is negative. The most common causes for AIHA associated with a negative DAT are RBC-bound IgG below the sensitivity threshold of the DAT, RBC-bound IgA and IgM not detectable by routine reagents, and low-affinity IgG that dissociates during the testing process. Samples submitted from 800 patients with hemolytic anemia and a negative DAT were tested by an antiglobulin sera (AGS) panel of anti-IgG, anti-C3, anti-IgM, and anti-IgA by a routine DAT. Additional tests included a direct Polybrene test to detect small amounts of RBCbound IgG, a cold-wash technique to detect low-affinity IgG, and a DAT by gel test with anti-IgG. A positive result was obtained with at least one method for 431 (54%) of 800 specimens tested. The AGS panel was positive for 400 (50%) of samples, with IgG or C3 or both accounting for reactivity in 48 percent. IgA alone was found on 2 percent of samples; IgM was never found alone. Lowaffinity IgG was found on 37 (5%) samples. The direct Polybrene test was the only positive test for 15 (2%) samples. The gel anti-IgG test was never the only positive test. Clinical correlations for these data were not available; however, previously published correlations suggest a positive predictive value for tests that extend routine DAT methods in patients with DAT-negative AIHA. Immunohematology 2010;26:156-60.

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“…6 Some of these antibodies are detected by routine serologic methods while others are detected by polybrene or polyethylene glycol techniques. 7,8 Autoantibodies mimicking alloantibodies have been described by others. [9][10][11] Some of these have Rh specificity 12,13 and several examples of patients with multiple Rh autoantibodies have been reported.…”

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confidence: 95%

Warm autoimmune hemolytic anemia with mimicking anti-c and -E specificities

et al. 2002

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An 18-month-old male was admitted to a hospital with a hemoglobin of 4.1 g/dL and a reticulocyte count of 53 percent. There was no history of prior transfusion. Serologic evaluation revealed the presence of both a positive direct antiglobulin test (DAT) and an indirect antiglobulin test (IAT). The patient's red blood cells (RBCs) typed as group A, C-D-E-c+e+ (cde/cde). Evaluation of the IAT revealed the presence of anti-c and anti-E. All other major antibodies were ruled out. Upon adsorption of the patient's serum with ficin-treated Cde/Cde RBCs, both antibody specificities were adsorbed; however, the antibodies were not adsorbed with native (untreated) Cde/Cde RBCs. Furthermore, the autoantibody was not adsorbed by Rh null cells, thereby suggesting Rh specificity. The serum was incompatible with cde/cde RBCs and compatible with Cde/Cde RBCs. The patient was successfully transfused with Cde/Cde RBCs followed by resolution of his anemia, as evidenced by an increased and stable hemoglobin. It was concluded that the autoantibody had mimicking anti-c and -E specificities. This is a report of an unusual case of autoimmune hemolytic anemia because the Rh autoantibody appeared to have dual mimicking specificities, and the patient's RBCs were antigen negative for one of the antibody specificities, i.e., anti-E.

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Evaluation of the manual hexadimethrine bromide (Polybrene) technique in the investigation of autoimmune hemolytic anemia

Cited by 11 publications

References 7 publications

Diagnóstico laboratorial da anemia hemolítica auto-imune: características do teste manual direto do Polybrene<FONT FACE=Symbol>Ò</FONT>

Diagnóstico laboratorial da anemia hemolítica auto-imune: características do teste manual direto do Polybrene<FONT FACE=Symbol>Ò</FONT>

Attempts to support an immune etiology in 800 patients with direct antiglobulin test–negative hemolytic anemia

Warm autoimmune hemolytic anemia with mimicking anti-c and -E specificities

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