Gel Test Application for IgG Subclass Detection in Auto‐Immune Haemolytic Anaemia

Fabijańska-Mitek, Jadwiga; Thetaopienska, H.; ?upanska, B.

doi:10.1046/j.1423-0410.1997.7240233.x

Cited by 27 publications

(13 citation statements)

References 18 publications

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“…The patient populations to consider include alloimmunized transfusion patients, pregnant women with a possibility of HDN, and patients with autoimmune hemolytic anemia (AIHA). Detailed studies in AIHA patients have demonstrated that a mixture of IgG subclasses is the most common presentation, and has a stronger association with hemolysis than isolated IgG subclasses 14,15 . In such patients, the monoclonal anti-IgG would still pick up the anti-RBC antibodies, as a mixture of IgG subclasses is present.…”

Section: Discussionmentioning

confidence: 99%

Serological blind spots for variants of human IgG3 and IgG4 by a commonly used anti‐immunoglobulin reagent

et al. 2016

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Background Human IgG exists in 4 different subtypes (IgG1, IgG2, IgG3, and IgG4), but it is also now appreciated that there is genetic variation within IgG subtypes (called isoallotypes). 29 different isoallotypes have been described, with 7, 4, 15, and 3 isoallotypes described for IgG1-IgG4, respectively. The reactivity of anti-IgG with different isoallotypes has not been characterized. Study Design and Methods A novel monoclonal anti-K antibody (PUMA1) was isolated, sequenced, and a panel of PUMA1 variants was expressed consisting of the 29 known IgG isoallotypes. The resulting panel of antibodies was pre-incubated with K+ RBCs and was then subjected to testing with currently approved anti-IgG, by flow cytometry, solid phase systems, gel card, and tube testing. Results/Findings An FDA approved monoclonal anti-IgG (Gamma-clone) failed to recognize 2 out of 15 IgG3 isoallotypes (IgG3-03 and IgG3-13) and 3 out of 3 IgG4 isoallotypes (IgG4-01, 02, 03). In contrast, an FDA approved rabbit polyclonal anti-IgG recognized each of the known human IgG isoallotypes. Conclusion These findings demonstrate “blind spots” in isoalloantibody detection by a monoclonal anti-IgG. Should a patient have anti-RBC antibodies predominantly of an IgG3 subtype of the IgG3-03 and/or IgG3-13 variety, it is possible that a clinically significant alloantibody would be missed. IgG-03 and IgG-13 are estimated at a frequency of 1–3% of Caucasian and 20–30% of certain African populations. The non-reactivity with IgG4 is a known characteristic of this monoclonal anti-IgG, but IgG4 isoallotypes have not been previously reported.

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Section: Discussionmentioning

confidence: 99%

Serological blind spots for variants of human IgG3 and IgG4 by a commonly used anti‐immunoglobulin reagent

et al. 2016

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“…However, several isotypes are found simultaneously in 59% of patients with IgG-positive DAT. 7 These IgG isotypes influence the pathogenicity and the efficiency of immune clearance through the binding of several Fcg receptors on effectors cells. 3,4 Thus, the presence of the FcgRIIa131H as single allele which bind with more IgG isotypes may explain the association between FcgRIIa-131HH genotype and AIHA in WM patients by increasing the clearance of IgG opsonized red cells.…”

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confidence: 99%

“…5,6 However, in those studies, only HUMARA assay was performed to assess clonality, a methylation-based test that is not completely reliable for patients' samples analysis because of possible abnormal DNA methylation in malignancies. 7 We studied a series of female ET patients in whom XCIPs had previously been analyzed by our group using both gene methylation and expression assays in all hematopoietic cell lineages 1,2 for the presence of mutant JAK2 and tested if the mutation correlated with monoclonal phenotype that would be expected if JAK2 mutation plays a role in disease development.…”

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confidence: 99%

Autoimmune hemolytic anemias and IgG antierythrocyte autoantibodies in Waldenström's macroglobulinemia: association with FcγRIIa polymorphism

et al. 2006

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“…Commercially available microtubes containing either gel or microbeads can be used for red blood cell grouping, antibody screening and identification, as well as for cross-matching [1, 2]. They have also appeared to be useful in patients with autoimmune hemolytic anemia mainly for the detection of autoantibody and IgG subclass determination in ‘Coombs-negative’ anemia [3, 4]. Moreover, the microcolumn technology has the advantage that it is rapid, its interpretation is easy, and the results can be stored.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Microcolumn Technology for Pretransfusion Testing in Multiple Myeloma Patients

et al. 1998

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Objective: Microcolumn tests are useful for serological investigations, although because of their high sensitivity, false-positive results might be expected, e.g. in hypergammaglobulinemia. The aim of this study was to evaluate these tests in multiple myeloma. Methods: Pretransfusion testing was done in 80 patients with multiple myeloma using microcolumn and traditional tube tests. Results: All sera were negative in microcolumn indirect antiglobulin test and enzyme test, positive in 58% of samples in the enzyme tube test. The microcolumn direct antiglobulin test was positive in about 40% of samples but never in the tube direct antiglobulin test. This was not due to the presence of autoantibodies but to nonspecific binding of immunoglobulins related to their concentration in sera. Conclusion: Microcolumn tests appeared to be useful for pretransfusion testing in multiple myeloma in spite of positive autocontrols.

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Gel Test Application for IgG Subclass Detection in Auto‐Immune Haemolytic Anaemia

Abstract: The gel test is more sensitive than other procedures for the determination of IgG subclass and has the advantages of simplicity, rapidity, low cost, and stability of the agglutinates.

Cited by 27 publications

References 18 publications

Serological blind spots for variants of human IgG3 and IgG4 by a commonly used anti‐immunoglobulin reagent

Serological blind spots for variants of human IgG3 and IgG4 by a commonly used anti‐immunoglobulin reagent

Autoimmune hemolytic anemias and IgG antierythrocyte autoantibodies in Waldenström's macroglobulinemia: association with FcγRIIa polymorphism

Evaluation of the Microcolumn Technology for Pretransfusion Testing in Multiple Myeloma Patients

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