The First Example of Auto-Anti-M and its Consequences in Pregnancy

Fletcher, James; Zmijewski, C.M.

doi:10.1159/000230247

Cited by 20 publications

(7 citation statements)

References 2 publications

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“…The thermal amplitude of the auto anti-h1 antibodies described by Tegoli et a1. 2 and Fletcher et al 1 was such that they were initially apparent at 37 C and 20 C, respectively. The auto anti-M antibodies demonstrated in the sera of our patients consistently required a temperature of 4 C from the time of discovery.…”

Section: Discussionmentioning

confidence: 95%

Additional Examples of Cold Autoagglutinins with M Specificity

1973

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Examples of both anti-M and anti-N have been reported in patients possessing these antigens; however, in only two instances has anti-M been reported as an autoantibody. This paper describes two additional patients with auto anti-M. In each case the anti-M was shown to be an autoantibody by absorption and elution studies. Optimum reactivity was obtained at 4 C. Column chromatogaphy and 2-mercaptoethanol reduction indicated that the antibody was an IgM globulin. There was no evidence of autoimmune hemolysis in either of these patients.IT IS an extremely rare event for a cold a u t o a g g l u t i n i n t o manifest specificity other than anti-I. Recently, however, two cases of a u t o a n t i -M h a v e been r e p o r t e d in t h e literature. Fletcher and Zmijewskil found an a u t o a n t i -M in t h e serum of a pregnant woman w i t h o u t evidence of hemolytic disease. Tegoli et n1.2 also reported an a u t o a n t i -M in a p a t i e n t following liver transplantation. T w o a d d i t i o n a l p a t i e n t s w i t h a u t o anti-M will be described. Case Report IA 37-year-old white female, who had been pregnant nine times, received two units of blood during an appendectomy and seven units during and after a Caesarean section four years previously. Shortly thereafter, symptoms resulting from anomalous communications between the coronary artery and the pulmonary trunk developcd. She was treated by operative ligation of the abnormal vcssels and received seven units of M negative blood during and after the operation. R e s u l t s T h e patient was typed as Group 0, Rho positive, MNs, U positive, P, positive. T h e patient's hl status was verified with two human and six rabbit anti-M sera. N o mixed field phenomena were observed: thus, the possibilities of chimerism or mosaicism were unlikely.T h e direct antiglobulin test was negative.T h e tests for antibody in the serum prior to the operation were positive only at 4 C. At this temperature all red blood cells in a commercial panel were agglutinated (Table 1). T h e p r e s ence of anti-M was suspected since it was observed that the strongest reactions occurred with homozygous M cells and the weakest with homozygous N cells. T h e patient's serum agglutinated homozygous N cells from an adult but not cord cells, suggesting the possibility of anti-I in addition to anti-M. Furthermore, reactions occurred with MN cord cells, demonstrating that the presence of the I antigen was not necessary for anti-M reactivity. Absorption at 0 C with the patient's ficin-treated cells completely removed the anti-I revealing anti-M. This absorbed serum was then reabsorbed at 0 C with the patient's nonficin-treated cells.

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Section: Discussionmentioning

confidence: 95%

Additional Examples of Cold Autoagglutinins with M Specificity

1973

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“…The anti-M was thought to have been passively transferred but later con firmed [17] as a true autologous antibody. The only other case reported is that by Fletcher and Zmijevksy [7] which appears to be the first report of a true autologous anti-M: it was detected in a pregnant woman. The reports of Schmidt and Taswell [25] and Konugres et al [10] differ in that anti-M was present with MN cells but the antigen was abnormal and did not react with the antibody.…”

Section: Discussionmentioning

confidence: 96%

“…It is usually found in NN individuals, but exceptions have been found [7,26] where the antibody occurred in MN persons. Anti-N is still considered an infrequent finding, and even rarer is its occurrence in someone possessing the antigen.…”

Section: Introductionmentioning

confidence: 99%

Naturally-Occurring Anti-M and Anti-N with Special Case: IgG Anti-N in a NN Donor

Perrault¹

1973

Vox Sanguinis

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Routine red cell antibody screening using a low-ionic strength-Polybrene Auto-Analyzer has revealed the frequent occurrence of anti-M : 62 cases in M negative and 2 in M positive individuals. Anti-N was encountered in 8 cases : 6 in MN individuals and 1 in a MM patient, and 1 was found in a NN healthy blood donor. The latter antibody was the strongest detected and proved to be an IgG cold-reacting antibody, with no evidence of in vivo activity in a donor with an apparently normal N antigen. The Auto- Analyzer titer of this anti-N was 1:256. Saline agglutination with 2% cells was negative but with 10% cell suspension, a titer of 1:16 to 1:32 was obtained.

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“…A pro gramme of plasmapheresis was commenced, a total of eight phereses being performed in a 3-week period from 31st October to 21st November Anti-M occurring as an autoantibody is very rare. Fletcher and Zmijewski [5] de scribed the first example in 1970 in a healthy pregnant woman. Since then 6 other cases have been reported [4,[8][9][10], all in females, in association with a variety of clinical situa tions including Raynaud's phenomenon, he patic transplantation and chronic aggressive hepatitis.…”

Section: Introductionmentioning

confidence: 99%

Auto Anti-M Antibody Following Renal Transplantation

Lown¹,

Barr²,

Kelly³

1980

Vox Sanguinis

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A 25-year-old man with rapidly progressive glomerulonephritis developed an autoantibody with anti-M specificity following haemodialysis and renal transplantation. The patient’s red cells typed as MN. The antibody was an IgM globulin which displayed marked dosage effect and variable pH dependence. The thermal range of reactivity extended to 37 ° C. The stimulus for the production of the antibody is uncertain.

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The First Example of Auto-Anti-M and its Consequences in Pregnancy

Cited by 20 publications

References 2 publications

Additional Examples of Cold Autoagglutinins with M Specificity

Additional Examples of Cold Autoagglutinins with M Specificity

Naturally-Occurring Anti-M and Anti-N with Special Case: IgG Anti-N in a NN Donor

Auto Anti-M Antibody Following Renal Transplantation

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