T-cryptantigen (TCA) activation in sever pneumonia complicated with multiple organ failure

Wang, Qiushi; Liu, Delong; Bai, Yingzhe

doi:10.1016/j.transci.2010.10.008

Cited by 3 publications

(4 citation statements)

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“…Amost all of MODS patients have SIRS in the development of the disease. [6] SIRS is thought to be an inevitable pathophysiological process in the development of MODS. [18] The disease will continue to progress and the body of SIRS patients will be damaged by new factors as a "second hit".…”

Section: Discussionmentioning

confidence: 99%

Prognostic significance of urokinase-type plasminogen activator and its receptor in patients with systemic inflammatory response syndrome

Liu

Ding

et al. 2011

World Journal of Emergency Medicine

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BACKGROUND: This study aimed to determine the plasma levels of urokinase-type plasminogen activator (uPA), urokinase-type plasminogen activator receptor (uPAR), D-dimer, IL-6 and TNF-α, and observe the relations among uPA, uPAR, D-dimer, IL-6 and TNF-α in patients with systemic infl ammatory response syndrome (SIRS). METHODS:A prospective, clinical case-control study was conducted in patients with SIRS at age of more than 55 years old treated during 2008-2010 at Wuhan Central Hospital. Venous blood samples were collected by routine venipuncture. Eighty-five patients were divided into two groups according to diagnostic criteria of SIRS: SIRS patients from intensive care units (n=50), and non-SIRS patients from medical wards (n=35). Thirty healthy blood donors who visited the General Health Check-up Division at Wuhan Central Hospital served as controls. Excluded from the study were (1) those patients with pregnancy; (2) those with cancer; (3) those died after admission into the ICU in 7 days; (4) those received cardiopulmonary resuscitation; (5) those who had previous blood system diseases; and (6) those with SIRS before admission into the ICU. The levels of uPA, uPAR, D-D, IL-6 and TNF-α in blood were detected by commercial enzyme-linked immunosorbent assay (ELISA) kit. The data were analyzed using SPSS version 17.0 and expressed as mean ± standard. Student's t test and the Mann-Whitney U test were used in the analysis. The relations of uPA, uPAR and D-dimer, IL-6 TNF-α levels were analyzed using Spearman's rank-order correlation coeffi cient test. RESULTS:The plasma levels of uPA , uPAR, D-dimer,IL-6 and TNF-α in the patients with SIRS were obviously higher than those in the non-SIRS patients and controls (P<0.001). Correlation analysis showed a positive correlation between uPAR and IL-6 levels (r=0.395, P=0.004) and between uPAR and TNF-α levels (r=0.606, P<0.001), but no correlation between uPAR and D-dimer levels (r=0. 069, P=0.632). No correlation was observed between uPA, D-dimer, IL-6 and TNF-α levels (P>0.05). The establishment of ROC curve was based on the levels of uPAR, D-dimer, IL-6 and TNF-α in 24 hours for the diagnosis of multiple organ dysfunction syndrome (MODS), and the ROC areas under the curve were 0.76, 0.58, 0.86 and 0.83, respectively.CONCLUSIONS: uPA and uPAR play a major role in patients with SIRS in the process of coagulation disorder, but the mechanism of SIRS is not the same. uPAR may play a central role in the development of SIRS to MODS.

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Section: Discussionmentioning

confidence: 99%

Prognostic significance of urokinase-type plasminogen activator and its receptor in patients with systemic inflammatory response syndrome

Liu

Ding

et al. 2011

World Journal of Emergency Medicine

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“…Patients with hemolytic uremic syndrome are particularly at risk of prompt deterioration, disseminated intravascular coagulopathy and irreversible multiorgan system failure. Judicious transfusion of washed blood products must be meticulous . Despite ventilatory, inotropic and antimicrobial supports, PICU mortality remains high.…”

Section: Discussionmentioning

confidence: 99%

Cardiopulmonary morbidity of streptococcal infections in a PICU

Hon

Leung

et al. 2014

Clinical Respiratory J

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“…4 However, it is more common for hemolysis to occur after the transfusion of blood components that contain plasma. [5][6][7] Thrombocytopenia may develop because of the presence of the cryptantigen on platelets (PLTs). 8,9 In addition, coagulopathies, such as disseminated intravascular coagulation (DIC), often occur.…”

mentioning

confidence: 99%

“…8,9 In addition, coagulopathies, such as disseminated intravascular coagulation (DIC), often occur. 5,10 In the past, polyagglutination was readily detected by blood centers when ABO typing resulted in ABO discrepancies. 8,11 This finding occurred because human-source sera containing antibodies against cryptantigens were used for blood typing.…”

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confidence: 99%

Hematologic complications in a patient with Glycine soja polyagglutination following fresh frozen plasma transfusion

et al. 2017

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Polyagglutination is a rare and underdiagnosed condition, characterized by agglutination of red blood cells (RBCs) with almost all ABO-compatible adult sera. Polyagglutination can occur when a cryptantigen is exposed on RBCs via microbial enzyme activity. Because nearly all adults naturally produce antibodies against cryptantigens, transfusion of plasma can cause unexpected hemolysis and hematologic complications, such as thrombocytopenia and disseminated intravascular coagulation, in patients whose cryptantigens are exposed. We report a case of Glycine soja polyagglutination occurring in a 60-year-old African-American man with disseminated methicillin-resistant Staphylococcus aureus (MRSA) infection. Prior to transfusion, the patient developed severe anemia of unknown etiology. Following transfusion of 3 units of fresh frozen plasma (FFP), his RBC count could not be determined for 24 days because of RBC agglutination in his blood sample. In addition, the FFP transfusion correlated with the rapid development of severe, transfusionrefractory thrombocytopenia and anemia. The perplexed clinical team consulted the blood bank. A direct antiglobulin test demonstrated 1+ mixed-field reactivity with both monoclonal anti-IgG and anti-C3d. Lectin panel testing showed reactivity with only Glycine soja, confirming the condition. Subsequently, plasma components were avoided, and RBC and platelet (PLT) components were washed prior to transfusion. After a 44-day hospitalization involving the transfusion of 22 units of RBCs and 13 units of PLTs, the patient was discharged to a long-term care facility. The patient's confounding hematologic complications can best be explained by polyagglutination, which developed secondary to the severe MRSA infection. The FFP transfusion likely passively transferred antibodies that bound to the patient's RBC cryptantigens, leading to RBC agglutination and anemia. The development of severe thrombocytopenia may be related to cryptantigen exposure on the patient's PLTs. Although difficult to identify, polyagglutination needs to be recognized to appropriately manage hemotherapy. The purpose of this case study is to report hematologic complications following FFP transfusion in a patient with Glycine soja polyagglutination, a rarely described condition.

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T-cryptantigen (TCA) activation in sever pneumonia complicated with multiple organ failure

Cited by 3 publications

References 9 publications

Prognostic significance of urokinase-type plasminogen activator and its receptor in patients with systemic inflammatory response syndrome

Prognostic significance of urokinase-type plasminogen activator and its receptor in patients with systemic inflammatory response syndrome

Cardiopulmonary morbidity of streptococcal infections in a PICU

Hematologic complications in a patient with Glycine soja polyagglutination following fresh frozen plasma transfusion

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