Medicine Hematology

Blood groups and transfusion

Description

This cluster of papers explores the relationship between blood group variants, such as ABO and Rh, and various diseases including autoimmune hemolytic anemia, fetal anemia, COVID-19 susceptibility, and pancreatic cancer. It also investigates the impact of alloimmunization and RBC antigens on transfusion outcomes and disease risk.

Keywords

Blood Groups; Alloimmunization; Anemia; ABO Locus; RBC Antigens; Autoimmune Hemolytic Anemia; Fetal Anemia; COVID-19 Susceptibility; Pancreatic Cancer; von Willebrand Factor

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Summary The antibody in agar plate test has proved valuable for the quantitative measurement of individual serum immunoglobulins. With this technique, specific antiserum is mixed uniformly in an agar gel … Summary The antibody in agar plate test has proved valuable for the quantitative measurement of individual serum immunoglobulins. With this technique, specific antiserum is mixed uniformly in an agar gel plate. Antigen containing solutions are placed in small antigen wells cut in the agar. A concentric ring of antigen: antibody precipitate forms around the antigen well. By graphically comparing the ring diameters with those of appropriate standards, the protein concentration of the test sera can be determined. The probable error in measurement of normal serum immunoglobulins is ±10%. This procedure has been used to quantify protein concentrations as low as 0.003 mg/ml. Multiple samples can be easily tested and less than 0.1 ml of sample is required. The mean immunoglobulin levels in 20 normal human sera were found to be 12.4 mg/ml for IgG (7 S γ2-globulins); 2.8 mg/ml for IgA (γ1A or β2A-globulins) and 1.23 mg/ml for the IgM (18 S γ1M-globulins). Type K (I) and Type L (II) immunoglobulins were similarly determined. The results by the antibody-agar plate method are similar to those obtained by the isotopic immune inhibition technique, except for the serum IgA and Type K (I) and Type L (II) immunoglobulin levels. With each of these proteins the values obtained by the isotopic immune inhibition test are higher than those found by the antibody-agar plate test. The basis for this difference is discussed.
Summary The immunoglobulin having reaginic activity was purified from sera of ragweed sensitive patients by salt precipitation, diethylaminoethyl (DEAE)-cellulose column chromatography, gel filtration and DEAE-Sephadex column chromatography. The γG- and … Summary The immunoglobulin having reaginic activity was purified from sera of ragweed sensitive patients by salt precipitation, diethylaminoethyl (DEAE)-cellulose column chromatography, gel filtration and DEAE-Sephadex column chromatography. The γG- and γA-globulins remaining in the purified samples were absorbed with rabbit anti-γG- and anti-γA-antibodies which had been precipitated with goat antibody against rabbit γ-globulin. On a weight basis, reaginic activity of the final preparation was about 1000 times more active than the original sera and the most active fraction gave positive P-K reactions at a dilution of 1:80,000. Human serum proteins detected in the preparation were γE- and γD-globulins. The antibody against antigen E was detected in γE-globulin but not in other immunoglobulins. It was also found that the reaginic activity and γE-antibody in the preparations were precipitated by anti-γE-antibody. The results indicate that reaginic activity is associated with γE-globulin. Evidence was presented that reaginic antibody against antigen E in the serum of one individual was γE-globulin of mostly κ chain type.
New automated blood cell analyzers provide an index of red cell volume distribution width (RDW) or heterogeneity and a histogram display of red cell volume distribution. We have developed a … New automated blood cell analyzers provide an index of red cell volume distribution width (RDW) or heterogeneity and a histogram display of red cell volume distribution. We have developed a classification of red cell disorders, based on mean corpuscular volume (MCV) or red cell size, heterogeneity, and histograms, to guide diagnosis from the peripheral blood analysis. The distinction of iron deficiency anemia from heterozygous thalassemia or the anemia of chronic disease and the detection of early iron and folate deficiency is improved. Red cell volume distribution histograms identify red cell fragmentation or agglutination, dimorphic populations, and artifactual counting of lymphocytes as red cells. We recommend the use of these new variables in the initial classification of anemia by the practicing physician.
The hemolysis of sheep red blood cells (SRBC) occurs via the classical complement pathway and is blocked by ethylene glycol bis-amino tetraacetate (EGTA). By contrast, fresh normal human serum in … The hemolysis of sheep red blood cells (SRBC) occurs via the classical complement pathway and is blocked by ethylene glycol bis-amino tetraacetate (EGTA). By contrast, fresh normal human serum in EGTA buffer was found to cause >90% hemolysis of unsensitized rabbit red blood cells (RaRBC) at a final dilution of 1:15. Absorbing human serum with RaRBC at 0°C will remove only 45% of this hemolytic activity and the same activity is present in human hypogammaglobulinemic serum. When rabbit lymphocytes were incubated with human serum in EGTA buffer, complement fixation occurred on their surface which was demonstrated with radiolabeled antibodies to human C3 or as “blocking” of the complement receptor. With purified complement components it was shown that the EGTA buffer completely blocked C1 but not C4, C2, or the late complement components. These findings show that a rabbit cell surface component can activate the alternate pathway of complement in human serum and suggest that this activation does not involve antibody.
Summary A microtechnique (modified Takatsy) is described which can be applied to complement fixation, hemagglutination, hemagglutination inhibition and metabolic inhibition tests. The system permits an 8-fold saving of reagents and … Summary A microtechnique (modified Takatsy) is described which can be applied to complement fixation, hemagglutination, hemagglutination inhibition and metabolic inhibition tests. The system permits an 8-fold saving of reagents and rapid performance of microdilutions. The specific methods and modifications of equipment necessary to obtain reliable results are presented in detail. Comparative data obtained with the micro- and standard systems establish the reliability and validity of the microsystem.
Blood group antigens represent polymorphic traits inherited among individuals and populations. At present, there are 34 recognized human blood groups and hundreds of individual blood group antigens and alleles. Differences … Blood group antigens represent polymorphic traits inherited among individuals and populations. At present, there are 34 recognized human blood groups and hundreds of individual blood group antigens and alleles. Differences in blood group antigen expression can increase or decrease host susceptibility to many infections. Blood groups can play a direct role in infection by serving as receptors and/or coreceptors for microorganisms, parasites, and viruses. In addition, many blood group antigens facilitate intracellular uptake, signal transduction, or adhesion through the organization of membrane microdomains. Several blood groups can modify the innate immune response to infection. Several distinct phenotypes associated with increased host resistance to malaria are overrepresented in populations living in areas where malaria is endemic, as a result of evolutionary pressures. Microorganisms can also stimulate antibodies against blood group antigens, including ABO, T, and Kell. Finally, there is a symbiotic relationship between blood group expression and maturation of the gastrointestinal microbiome.
Transfusion therapy for sickle cell anemia is limited by the development of antibodies to foreign red cells. To evaluate the frequency and risk factors associated with such alloimmunization, we determined … Transfusion therapy for sickle cell anemia is limited by the development of antibodies to foreign red cells. To evaluate the frequency and risk factors associated with such alloimmunization, we determined the transfusion history, red-cell phenotype, and development of alloantibodies in 107 black patients with sickle cell anemia who received transfusions. We compared the results with those from similar studies in 51 black patients with sickle cell disease who had not received transfusions and in 19 nonblack patients who received transfusions for other forms of chronic anemia. We assessed the effect that racial differences might have on the frequency of alloimmunization by comparing the red-cell phenotypes of patients and blood-bank donors (n = 200, 90 percent white).
By using the two criteria (a) high density of immunoglobulin determinants on the cell surface and (b) presence of receptors for C'3 on the cell surface for defining bone marrow-derived … By using the two criteria (a) high density of immunoglobulin determinants on the cell surface and (b) presence of receptors for C'3 on the cell surface for defining bone marrow-derived lymphocytes, it is indirectly shown that all or at least a major population of human thymus-derived lymphocytes under certain conditions will form nonimmune rosettes with sheep red blood cells (SRBC). Almost all thymocytes tested from two different donors formed rosettes. The SRBC rosettes are not formed by virtue of immunoglobulin receptors and form only around living cells. Positive bivalent ions are required for rosette formation since EDTA will block rosette formation. Sodium iodoacetate will also block rosette formation demonstrating the dependence on an intact glycolytic pathway. Rosette formation is temperature dependent and will not appear at 37°C. Trypsin treatment of lymphocytes will abolish their SRBC-binding ability which cannot be restored by treating them with fresh donor serum or fetal calf serum, but which will reappear after culturing the lymphocytes. It is suggested that these rosettes are formed by a rapidly released or metabolized receptor substance on the living cell surface which behaves as a trypsin-sensitive structure produced by the cells themselves.
Abstract Red blood cell (RBC) autoantibodies are a relatively uncommon cause of anemia. However, autoimmune hemolytic anemia (AIHA) must be considered in the differential diagnosis of hemolytic anemias, especially if … Abstract Red blood cell (RBC) autoantibodies are a relatively uncommon cause of anemia. However, autoimmune hemolytic anemia (AIHA) must be considered in the differential diagnosis of hemolytic anemias, especially if the patient has a concomitant lymphoproliferative disorder, autoimmune disease, or viral or mycoplasmal infection. Classifications of AIHA include warm AIHA, cold agglutinin syndrome, paroxysmal cold hemoglobinuria, mixed‐type AIHA, and drug‐induced AIHA. Characteristics of the autoantibodies are responsible for the various clinical entities. As a result, diagnosis is based on the clinical presentation and a serologic work‐up. For each classification of AIHA, this review discusses the demographics, etiology, clinical presentation, laboratory evaluation, and treatment options. Am. J. Hematol. 69:258–271, 2002. © 2002 Wiley‐Liss, Inc.
Sheep red blood cells sensitized by 7S, but not by 19S rabbit anti-Forssman antibodies, adhere and form rosettes on mouse macrophages and on a few monocytes and polymorphonuclear cells (PMN). … Sheep red blood cells sensitized by 7S, but not by 19S rabbit anti-Forssman antibodies, adhere and form rosettes on mouse macrophages and on a few monocytes and polymorphonuclear cells (PMN). When, however, C' factors from mouse serum are added to the antigen-19S antibody complex (EAC'), rosettes are formed on most mouse peritoneal macrophages and PMN and on a few monocytes. In addition EAC' also adheres to 10-25% of lymph node lymphocytes but not to thymus lymphocytes. EAC' prepared with 7S anti-Forssman antibodies has identical properties. The adherence of red cells induces an increase in the membrane activity of the leukocytes and causes injury to the red cells which rapidly become deformed and fragmented. Adherence of EAC' occurs at 37 degrees C and is minimal at 4 degrees C. Probably only the first four C' components are involved in this phenomenon as mouse serum deficient in C'5 or rabbit serum, deficient in C'6 can be used as a source of C' components. Treatment of EAC' with EDTA does not modify its leukocyte-adherence properties. The adherence of EAC' to the leukocytes is not inhibited in the presence of serum. The receptors for C' on macrophages, PMN, and monocytes differ from those found on lymphocytes. Rosette formation by EAC' on macrophages, PMN, and monocytes depends on divalent cations (Mg(++)) and can be reversed by Na(3)H EDTA, while adherence to lymphocytes is independent of these ions and occurs in the presence of 0.01 M Na(3)H EDTA. Both types of receptors for C' components are destroyed by trypsin treatment of the leukocytes, in contrast with the receptors for 7S antibodies on the same cells which persist after enzyme treatment.
Journal Article The Eagle Effect Revisited: Efficacy of Clindamycin, Erythromycin, and Penicillin in the Treatment of Streptococcal Myositis Get access Dennis L. Stevens, Dennis L. Stevens Please address requests for … Journal Article The Eagle Effect Revisited: Efficacy of Clindamycin, Erythromycin, and Penicillin in the Treatment of Streptococcal Myositis Get access Dennis L. Stevens, Dennis L. Stevens Please address requests for reprints to Dr. Dennis L. Stevens, Infectious Disease Section, Veterans Administration Medical Center, 500 West Fort Street, Boise, Idaho 83702. Search for other works by this author on: Oxford Academic PubMed Google Scholar Amy E. Gibbons, Amy E. Gibbons Search for other works by this author on: Oxford Academic PubMed Google Scholar Roberta Bergstrom, Roberta Bergstrom Search for other works by this author on: Oxford Academic PubMed Google Scholar Virginia Winn Virginia Winn Search for other works by this author on: Oxford Academic PubMed Google Scholar The Journal of Infectious Diseases, Volume 158, Issue 1, July 1988, Pages 23–28, https://doi.org/10.1093/infdis/158.1.23 Published: 01 July 1988 Article history Received: 22 September 1987 Revision received: 11 January 1988 Published: 01 July 1988
Several workers have observed that there is an extremely close immunological resemblance between the serum albumins of apes and man. Our studies with the quantitative micro-complement fixation method confirm this … Several workers have observed that there is an extremely close immunological resemblance between the serum albumins of apes and man. Our studies with the quantitative micro-complement fixation method confirm this observation. To explain the closeness of the resemblance, previous workers suggested that there has been a slowing down of albumin evolution since the time of divergence of apes and man. Recent evidence, however, indicates that the albumin molecule has evolved at a steady rate. Hence, we suggest that apes and man have a more recent common ancestry than is usually supposed. Our calculations lead to the suggestion that, if man and Old World monkeys last shared a common ancestor 30 million years ago, then man and African apes shared a common ancestor 5 million years ago, that is, in the Pliocene era.
ADVERTISEMENT RETURN TO ISSUEPREVArticleNEXTQuantitative procedures for use with the Edman-Begg sequenator. Partial sequences of two unusual immunoglobulin light chains, Rzf and SacO. Smithies, D. Gibson, E. M. Fanning, R. M. … ADVERTISEMENT RETURN TO ISSUEPREVArticleNEXTQuantitative procedures for use with the Edman-Begg sequenator. Partial sequences of two unusual immunoglobulin light chains, Rzf and SacO. Smithies, D. Gibson, E. M. Fanning, R. M. Goodfliesh, J. G. Gilman, and D. L. BallantyneCite this: Biochemistry 1971, 10, 26, 4912–4921Publication Date (Print):December 1, 1971Publication History Published online1 May 2002Published inissue 1 December 1971https://pubs.acs.org/doi/10.1021/bi00802a013https://doi.org/10.1021/bi00802a013research-articleACS PublicationsRequest reuse permissionsArticle Views63Altmetric-Citations489LEARN ABOUT THESE METRICSArticle Views are the COUNTER-compliant sum of full text article downloads since November 2008 (both PDF and HTML) across all institutions and individuals. These metrics are regularly updated to reflect usage leading up to the last few days.Citations are the number of other articles citing this article, calculated by Crossref and updated daily. Find more information about Crossref citation counts.The Altmetric Attention Score is a quantitative measure of the attention that a research article has received online. Clicking on the donut icon will load a page at altmetric.com with additional details about the score and the social media presence for the given article. Find more information on the Altmetric Attention Score and how the score is calculated. Share Add toView InAdd Full Text with ReferenceAdd Description ExportRISCitationCitation and abstractCitation and referencesMore Options Share onFacebookTwitterWechatLinked InRedditEmail Other access optionsGet e-AlertscloseSupporting Info (1)»Supporting Information Supporting Information Get e-Alerts
Inherited deficiencies of the complement proteins are rare in unselected populations. Examination of patients with the clinical correlates of complement deficiency (autoimmune disease and certain bacterial infections) shows the frequency … Inherited deficiencies of the complement proteins are rare in unselected populations. Examination of patients with the clinical correlates of complement deficiency (autoimmune disease and certain bacterial infections) shows the frequency of inherited complement deficiency to rise enormously (5.9% of patients with systemic lupus erythematosus, 10 to 25% of adults with sporadic meningococcal disease). Autoimmune diseases of all types, but especially systemic lupus erythematosus, discoid lupus and glomerulonephritis, are seen in all categories of complement deficiency, most typically in those of the early classical pathway (C1, C4, C2). Pneumococcal infections are characteristic of deficiencies of the early classical pathway, as well. Deficiencies of C3 are associated with severe disease including autoimmune phenomena, pneumococcal and neisserial infections. C3-deficient patients become ill substantially earlier in life. Infections with N. meningitidis and N. gonorrhoeae are most typical of the late component deficiencies, with over 40% of homozygotes affected. Despite the presence of this deficiency from birth and the peak age-specific incidence of meningococcal disease in the general population at ages 3-8 months, the median age of first infection in the late component-deficient patients is 17 years. Relapse of infection is ten times more common in these patients, and discrete recurrences are seen in 45% of affected individuals. An unusual and unexplained predilection for infection with serogroup Y N. meningitidis exists. Despite an immune deficiency, and problems with ascertainment bias, it appears that persons with late component complement deficiency enjoy less mortality than normals who contract meningococcal disease. Attempts to explain the pathogenesis of neisserial infection in late component deficiencies have focused on the concept that normally non-pathogenic serum-sensitive bacteria are etiologic in the absence of serum bactericidal activity. Data to support this concept remain to be developed and contrary data exist. A separate mechanism may predispose properdin-deficient patients to meningococcal infection, since they appear to develop fulminant infections with high mortality.
Through the use of absorbed idiotypic antisera prepared against single isolated monoclonal IgM anti-γ-globulins, partial cross-idiotypic specificity was demonstrated with other IgM anti-γ-globulins. Such antisera classified these proteins into at … Through the use of absorbed idiotypic antisera prepared against single isolated monoclonal IgM anti-γ-globulins, partial cross-idiotypic specificity was demonstrated with other IgM anti-γ-globulins. Such antisera classified these proteins into at least three groups. The major group which included 60% of the anti-γ-globulins was particularly homogeneous. The anti-γ-globulin specific antigens were detected best in hemagglutination and hemagglutination inhibition systems. They were not found in monoclonal IgM proteins that lacked anti-γ-globulin activity although related antigens were detected at low concentrations in pooled immunoglobulin preparations as well as in heterogeneous anti-Rh antibodies. Several lines of evidence were obtained indicating that the antibody combining site was involved in the specific determinants. Attempts were made to analyze the fine specificity of each anti-γ-globulin for the Fc fragment of different subclasses of human immunoglobulins as well as those of other species. Differences were observed but these were not readily related to the cross-specificity antigens. The anti-γ-globulin specific antigens were very analogous to those previously described for monoclonal IgM cold agglutinins. Although each protein could be distinguished from all the others on the basis of individual idiotypic antigens, the antigens common to the specific groups of proteins with each of these activities were prominent and readily detected with multiple antisera. The results indicate basic similarities between proteins of a given activity even in unrelated individuals.
Summary The passive hemagglutination procedure using a chromium chloride solution to bind antigens and antibodies to red cells has been investigated. The CrCl3 method of coating red cells is rapid … Summary The passive hemagglutination procedure using a chromium chloride solution to bind antigens and antibodies to red cells has been investigated. The CrCl3 method of coating red cells is rapid and simple, and serologic sensitivity and immunologic specificity are retained. The present studies showed that group O human red cells coated with antigen by the CrCl3 procedure can be used in a number of serologic reactions. In particular, use of CrCl3-treated cells as immunoadsorbent provides a rapid method for the preparation of monospecific antisera to human immunoglobulins. The immunoglobulin content of pathologic sera can be estimated by the degree to which the pathologic serum inhibits an appropriate agglutination system consisting of cells coated with γG-, γA- or γM-globulin by the CrCl3 method and of homologous antibody. “Purified” immunoglobulin preparations can be assessed for contamination by similar inhibition of agglutination of red cells coated with immunoglobulins by the CrCl3 method.
Previous in vitro studies have shown that immune complexes (IC) that fix complement can bind to the C3b receptor on primate erythrocytes. The in vivo function of this erythrocyte receptor, … Previous in vitro studies have shown that immune complexes (IC) that fix complement can bind to the C3b receptor on primate erythrocytes. The in vivo function of this erythrocyte receptor, however, is unknown. This study was undertaken to determine whether the binding of IC to erythrocytes in vivo might play a role in the removal of IC from the circulation. Baboons and rhesus monkeys were prepared with a catheter in the ascending aorta to infuse IC and in the abdominal aorta, renal, hepatic, and portal veins to monitor changes in binding and clearance of IC across kidney, liver, and spleen + gut, respectively. Autologous 51Cr-labeled erythrocytes were infused intravenously and allowed to equilibrate. Preformed IC (125I-labeled bovine serum albumin [BSA] rabbit anti-BSA) were then infused into the ascending aorta at a constant rate for 120 s. Blood samples were drawn at frequent intervals for 30 min from all catheters below the IC injection site. Each blood sample was then centrifuged on percoll to separate IC bound to erythrocytes from IC in plasma or bound to buffy coat cells. This resulted in an "erythrocyte fraction" beneath the percoll that contained the IC bound to erythrocytes, and a "plasma/buffy coat fraction" above the percoll that contained the IC in plasma and IC bound to buffy coat cells. Analysis of these data showed that the majority of the IC infused into the circulation rapidly became bound to erythrocytes. However, by 5 min after beginning the IC infusion, most of this IC load had been removed from the erythrocytes as they traversed the liver. In contrast, IC on erythrocytes did not deposit in kidney. The IC-bearing erythrocytes themselves were not trapped or detained by any organ. IC in the plasma/buffy coat fraction of blood were removed from the circulation but at a relatively low rate and almost entirely by the liver. These findings suggest that primate erythrocytes intercept large complement-fixing IC in the circulation causing the IC to adhere to the erythrocyte until th e IC-bearing erythrocyte traverses liver where the IC is deposited, and the erythrocyte is returned to the circulation. This primate erythrocyte-IC-clearing mechanism may be important in the protection against diseases mediated by deposition of circulating IC.
Invasive techniques such as amniocentesis and cordocentesis are used for diagnosis and treatment in fetuses at risk for anemia due to maternal red-cell alloimmunization. The purpose of our study was … Invasive techniques such as amniocentesis and cordocentesis are used for diagnosis and treatment in fetuses at risk for anemia due to maternal red-cell alloimmunization. The purpose of our study was to determine the value of noninvasive measurements of the velocity of blood flow in the fetal middle cerebral artery for the diagnosis of fetal anemia.
Abstract The novel coronavirus disease-2019 (COVID-19) has been spreading around the world rapidly and declared as a pandemic by WHO. Here, we compared the ABO blood group distribution in 2,173 … Abstract The novel coronavirus disease-2019 (COVID-19) has been spreading around the world rapidly and declared as a pandemic by WHO. Here, we compared the ABO blood group distribution in 2,173 patients with COVID-19 confirmed by SARS-CoV-2 test from three hospitals in Wuhan and Shenzhen, China with that in normal people from the corresponding regions. The results showed that blood group A was associated with a higher risk for acquiring COVID-19 compared with non-A blood groups, whereas blood group O was associated with a lower risk for the infection compared with non-O blood groups. This is the first observation of an association between the ABO blood type and COVID-19. It should be emphasized, however, that this is an early study with limitations. It would be premature to use this study to guide clinical practice at this time, but it should encourage further investigation of the relationship between the ABO blood group and the COVID-19 susceptibility.
Abstract To explore any relationship between the ABO blood group and the coronavirus disease 2019 (COVID-19) susceptibility, we compared ABO blood group distributions in 2173 COVID-19 patients with local control … Abstract To explore any relationship between the ABO blood group and the coronavirus disease 2019 (COVID-19) susceptibility, we compared ABO blood group distributions in 2173 COVID-19 patients with local control populations, and found that blood group A was associated with an increased risk of infection, whereas group O was associated with a decreased risk.
A hitherto unrecognized entity manifested by complete absence of gamma globulin with otherwise normal serum proteins and recurrent pneumococcal sepsis is described in an 8 year old male. The patient … A hitherto unrecognized entity manifested by complete absence of gamma globulin with otherwise normal serum proteins and recurrent pneumococcal sepsis is described in an 8 year old male. The patient appears to be normal in other respects and after extensive study no structural or functional change could be demonstrated in any body system although gamma globulin by electrophoretic analysis of his serum was consistently absent. He was unable to produce antibody for the pneumococcus with the four antigenic substances used; a positive Schick test persisted in spite of numerous attempts to reverse it with diphtheria toxoid. No antibody could be demonstrated following administration of typhoid vaccine in the usual manner and his serum was negative for complement-fixing antibodies of epidemic parotitis after he experienced a typical clinical picture of that disease. Gamma globulin could be demonstrated in his serum after concentrated immune human serum globulin was administered subcutaneously, and its gradual disappearance could be followed by electrophoretic analysis over a period of approximately six weeks. Concurrently, and following the administration of human globulin (3.2 gm. gamma globulin) at monthly intervals, he has been free of pneumococcal sepsis for more than a year, whereas he had experienced clinical sepsis at least 19 times in the previous four years in which eight different types of pneumococci had been recovered from blood culture during 10 different episodes. It is postulated that by some acquired "influence" the patient's antibody mechanism has been altered so that he is no longer able to synthesize and/or hold antibody to a specific organism. A complete defect of plasma proteins cannot be excluded.
The capacity possessed by some rabbit immune sera produced with blood of Rhesus monkeys, of reacting with human bloods that contain the agglutinogen M has been reported previously., Subsequently it … The capacity possessed by some rabbit immune sera produced with blood of Rhesus monkeys, of reacting with human bloods that contain the agglutinogen M has been reported previously., Subsequently it has been found that another individual property of human blood (which may be designated as Rh) can be detected by certain of these sera.Upon exhaustion of such a serum with selected bloods, for instance OM, the absorbed serum still agglutinated the majority (39 out of 45) of other human bloods, independently of the group or the M, N type; moreover, reactions took place with bloods lacking the property P. An example of the reactions is given in Table I.The results are of some interest in that they suggest a way of finding individual properties in human blood, namely, with the aid of immune sera against the blood of animals. As an analogy may be cited the demonstration of differences in sheep erythrocytes with immune sera for human A blood The reactions described, although of moderate intensity only, were obtained with immune sera produced at different times. Whether these observations may possibly lead to a method suitable for routine work is still under investigation.
Variability in blood donors, components, and recipients are known to affect transfusion outcomes, yet the combined effects of these factors remains unclear. The Red Blood Cell - Improving Transfusions for … Variability in blood donors, components, and recipients are known to affect transfusion outcomes, yet the combined effects of these factors remains unclear. The Red Blood Cell - Improving Transfusions for Chronically Transfused Recipients (RBC-IMPACT) study was a multi-center longitudinal study conducted in the United States (US) and Brazil over two years to investigate RBC survival after transfusion (Aim 1) and acute increase in iron post transfusion (Aim 2) (see https://clinicaltrials.gov/study/NCT05255445). The US RBC-IMPACT study included patients with thalassemia and sickle cell disease (SCD) and, in Aim 2 only, children with hematology-oncology diseases with a hypoproliferative bone marrow. In Brazil, the study was conducted within an established SCD cohort. Blood samples were collected immediately before and after RBC transfusion to measure hemoglobin (Hb), hemoglobin A (HbA) in SCD, and markers of iron and hemolysis. Samples were collected two hours post transfusion in a subset of participants receiving primarily single unit transfusions for Aim 2. Transfusate samples were collected from transfused units. Single nucleotide polymorphism array typing of donors and recipients to measure genetic variants including those associated with increased in vitro hemolysis of stored RBCs was conducted. Comprehensive information regarding donors, components and some recipient data were linked to key clinical data extracted from recipients' medical records to assess factors associated with RBC transfusion effectiveness. The outcomes for Aim 1 were RBC survival between successive transfusions, calculated as ΔHbA per day for SCD and by ΔHb per day for thalassemia, and Δbilirubin for both patient groups. The primary outcome for Aim 2 was change in serum iron from before to 2 hours after transfusion. This study will be the most detailed and granular evaluation of the predictive variables that may optimize RBC effectiveness and safety in these chronically transfused patient populations.
Introduction Azithromycin is first-line for uncomplicated Mycoplasma genitalium (Mgen) treatment in UK and European guidelines, however the rates of azithromycin resistance have increased significantly in recent years leading to higher … Introduction Azithromycin is first-line for uncomplicated Mycoplasma genitalium (Mgen) treatment in UK and European guidelines, however the rates of azithromycin resistance have increased significantly in recent years leading to higher rates of treatment failure. This study aims to review the disease epidemiology to guide service improvement. Methods We undertook a retrospective case note review of 1036 persons treated for Mgen over 1067 Mgen-related attendances. We obtained data on demographics, site(s) of infection, antibiotic resistance, treatment regimen received and results of test of cure. Results 71.1% ( n = 759) patients received the recommended first-line regimen of doxycycline and azithromycin. Moxifloxacin is the recommended first-line management for macrolide-resistant or complicated infection. 15% ( n = 155) patients received moxifloxacin alone as first-line treatment, and 6.9% ( n = 72) patients received doxycycline and moxifloxacin dual therapy. 72.9% ( n = 753) samples were successfully tested for macrolide resistance. Of these, 55.5% ( n = 418) showed macrolide resistance. 20.6% ( n = 7) showed fluoroquinolone resistance. Conclusions Resistance data show a macrolide resistance rate of 55.5% across our region, and at least 1 in 10 persons were inappropriately screened for Mgen. We propose a multi-pronged approach which includes strict adherence to testing criteria, local resistance testing, resistance-guided management as well as innovative approaches to improve test of cure rates.
Plasmodium falciparum strains lacking P. falciparum histidine-rich protein 2 (PfHRP2) and PfHRP3 threaten malaria rapid test reliability. We show that pfhrp2/pfhrp3-deleted parasites circulated in Ethiopia as early as 2009, before … Plasmodium falciparum strains lacking P. falciparum histidine-rich protein 2 (PfHRP2) and PfHRP3 threaten malaria rapid test reliability. We show that pfhrp2/pfhrp3-deleted parasites circulated in Ethiopia as early as 2009, before widespread PfHRP2-based rapid test use, and had high pfhrp3 deletion prevalence. Monitoring of pfhrp2 and of pfhrp3 deletions is needed.
Background Evidence indicates that genetic variations in the GYP(B-A-B) hybrid genes are associated with protection against malaria. Therefore, this study aims to characterize the GYP(B-A-B) hybrid alleles among northern Thais, … Background Evidence indicates that genetic variations in the GYP(B-A-B) hybrid genes are associated with protection against malaria. Therefore, this study aims to characterize the GYP(B-A-B) hybrid alleles among northern Thais, Burmese, and Karen with and without a previous history of malaria infection. Methods A total of 709 DNA samples were genotyped to identify GYP(B-A-B) hybrids using PCR-sequence specific primers (PCR-SSP) combined with Sanger sequencing. Additionally, some DNA samples ( n = 243) were also tested with high-resolution melting (HRM) analysis. Results In our sampled populations, 14/87 (16.0%), 3/34 (8.8%), 0/16 (0%), and 1/18 (5.6%) of northern Thais, Burmese, Karen, and other minorities in Myanmar with a previous history of malaria infection, respectively, were identified with GYP(B-A-B) hybrid genes, whereas individuals without a history of malaria infection were 24/155 (15.5%), 5/183 (2.6%), and 4/216 (1.9%) in northern Thais, Burmese, and Karen, respectively. In the latter groups, DNA sequences showed that 17/155 (11.0%) northern Thais were GYP*Mur/GYPB heterozygotes and the other 6/155 (3.9%) were GYP*Thai/GYPB heterozygotes. The remaining one (0.6%) sample was a GYP*Mur/GYP*Mur homozygote. Among Burmese, 3/183 (1.6%) were GYP*Mur/GYPB heterozygotes and 1/183 (0.5%) was GYP*Thai/GYPB heterozygote. The remaining one (0.5%) sample being a GYP*Mur/GYP*Mur homozygote. Among Karen samples, all four were GYP*Mur/GYPB heterozygotes. Conclusion Across all studied populations, GYP*Mur was the predominant allele, followed by GYP*Thai . In addition, genotyping results obtained by HRM were consistent with PCR-SSP combined with Sanger sequencing. A statistically non-significant association was noted for the glycophorin GYP(B-A-B) hybrids and malaria infection. Our findings provide insight into genetic variations of GYP(B-A-B) hybrid alleles among populations in the Thailand-Myanmar border area. This information could be used as a guideline to identify compatible blood products for transfusion and to prevent alloimmunization.
To describe therapeutic plasma exchange as treatment for severe acute hemolytic anemia resulting from human intravenous immunoglobulin (hIVIG) in a dog with primary immune-mediated thrombocytopenia (IMTP). A 4-year-old neutered female … To describe therapeutic plasma exchange as treatment for severe acute hemolytic anemia resulting from human intravenous immunoglobulin (hIVIG) in a dog with primary immune-mediated thrombocytopenia (IMTP). A 4-year-old neutered female Pomeranian with a recent diagnosis of IMTP presented with a potential relapse. Management with initial medications, including prednisolone and mycophenolate mofetil, was unsuccessful; therefore, the dog was administered hIVIG. Fifteen hours later, the patient developed an adverse reaction including vomiting and dark urine. Laboratory and clinical evidence of acute hemolysis was detected, including decreased hematocrit, hemoglobinemia from gross identification of serum, elevated total bilirubin, hemoglobinuria, and reticulocytosis. Supportive care for the dog was ineffective, and due to an adverse reaction characterized by severe salivation, a blood transfusion could not be done. Therapeutic plasma exchange (TPE) was performed to eliminate the causative agents, controlling the hemolytic anemia. After TPE, immunosuppressants were prescribed to treat the IMTP, which resolved 15 days later. At the time of this report, the patient is alive with no complications or clinical signs of IMTP. Acute hemolytic anemia caused by hIVIG is a rare adverse reaction in veterinary medicine. This is the first report of TPE being used to successfully treat this potentially life-threatening condition.
| AlQalam Journal of Medical and Applied Sciences
The distribution of ABO blood groups and Rh factors has been extensively studied, with findings typically similar on the most common blood group, although with regional variations in proportions. This … The distribution of ABO blood groups and Rh factors has been extensively studied, with findings typically similar on the most common blood group, although with regional variations in proportions. This study aimed to assess the prevalence of ABO and Rh blood group systems in the population of Sirte city. Data from 7,127 individuals (4,064 males and 3,063 females) were collected from the archives of the Sirte Passport Center. These records were compiled over intermittent intervals and represented residents from various areas within the city. Data analysis was performed using the Statistical Package for the Social Sciences (SPSS) software. The analysis revealed that blood group O was the most prevalent (54.6%), followed by group A (28.0%), group B (14%), and group AB (3.2%). Additionally, 11.3% of the population was Rh-negative. In Sirte, the distribution of ABO and Rh blood groups followed the pattern: O > A > B > AB, with Rh-positive being the predominant group. These findings are consistent with previous studies conducted in other Libyan cities.
Abstract Background Autoimmune hemolytic anemia (AIHA) is recognized to increase the risk of thrombotic events (TE), including venous thromboembolism (VTE) and arterial thromboembolism (ATE), but little is known about specific … Abstract Background Autoimmune hemolytic anemia (AIHA) is recognized to increase the risk of thrombotic events (TE), including venous thromboembolism (VTE) and arterial thromboembolism (ATE), but little is known about specific risk factors and characteristics. Methods This retrospective multicenter observational study, sought to assess TE incidence, identify associated thrombotic risk factors and assess the external validity of the Padua score in AIHA for predicting VTE. Results TE incidence during the study period was 25% (CI95%: 17–36), consisting of 19 VTE in 16 patients (18% [CI95%: 9–28]) and 11 ATE in 7 (8% [CI95%: 4–16]). A high number (≥ 5) of hemolysis attacks was associated with overall TE (OR 6.9 [CI95%: 1–82], p = 0.03). Univariate analysis confirmed splenectomy and VTE history as the strongest VTE-related risk factors (OR 7.5 [CI95%: 1–44], p = 0.009 and OR 3.8 [CI95%: 1–14], p = 0.04), whereas having primary warm AIHA was identified as a novel risk factor (3.1 [1–11] p = 0.05) which needs to be confirmed in further studies. ATE risk factors were age ≥ 80 years at diagnosis (OR 8.9 [CI95%: 1–68] p = 0.02), and having ≥ 3 cardiovascular risk factors (OR 8.9 [CI95%: 1–70] p = 0.01). The area under the Receiver Operating Characteristic curve of the Padua score was 0.66. Conclusions TE incidence is high in AIHA, especially when there are repeated hemolysis attacks and associated VTE and/or ATE-related risk factors, thus warranting the conduct of prospective clinical trials to allow for an improved TE risk stratification and to design adapted management for both VTE and ATE. Graphical Abstract
Background/Objectives: Pregnancies complicated by red cell alloimmunization can progress to hemolytic disease of the fetus and newborn (HDFN), requiring close monitoring and timely intervention to prevent fetal/neonatal morbidity and mortality. … Background/Objectives: Pregnancies complicated by red cell alloimmunization can progress to hemolytic disease of the fetus and newborn (HDFN), requiring close monitoring and timely intervention to prevent fetal/neonatal morbidity and mortality. This study investigated disease presentation, interventions, and outcomes in respondents with a history of alloimmunized pregnancy. Methods: This was a retrospective cross-sectional survey study administered online to alloimmunized patients between November 2022–February 2023. A total of 127 participants reported on 200 alloimmunized pregnancies. Distribution of pregnancy characteristics, antibodies and titers, monitoring, treatments and fetal outcomes were described and stratified where appropriate by fetal antigen status and disease severity. Outcomes and management practices in subsequent pregnancies following fetal loss to HDFN are reported. Results: Multiple antibodies were present in 42% of pregnancies with known antibody type (80/192). Titers reached critical levels (any titer for Anti-K; ≥16 for all other antibodies) in 71% (125/176) of pregnancies where titer was reported. Among fetal antigen positive pregnancies with critical titers, intrauterine transfusions were conducted in 40% (42/106), intravenous immunoglobulin was administered in 14% (15/106), plasmapheresis in 7% (7/106), and phenobarbital in 9% (9/106). Complications from transfusion were reported in 38% of pregnancies receiving intrauterine transfusion (17/45). Fetal death due to HDFN or complications from intrauterine transfusion was reported in 9% of antigen positive pregnancies with critical titers (10/106) and 16% of pregnancies receiving intrauterine transfusion (7/45). Conclusions: Disease presentation and severity complements previous research in this disease population, however, monitoring practices were diverse. Fetal death and intrauterine complication rates were higher than those previously reported in large international referral centers. Development of best practices and centralized referral centers may improve disease outcomes.
Erling Englund , Anders E. Henriksson | Scandinavian Journal of Clinical and Laboratory Investigation
Previous studies indicate that blood type O has a protective effect against Covid-19 disease. In the present study, we aimed to further explore and clarify the connection between ABO blood … Previous studies indicate that blood type O has a protective effect against Covid-19 disease. In the present study, we aimed to further explore and clarify the connection between ABO blood groups and the Covid-19 disease by examining the levels of Covid antibodies in patients with different ABO blood types. During the first pandemic year, and before the vaccine was available, SARS-CoV-2 antibody level were randomly analyzed at the regional hospital laboratory and the data was stored in the laboratory information system (LIS) Flexlab/Chemistry. The investigated cohort was created by cross-referencing the SARS-CoV-2 antibody results with the ABO Rh(D) blood group status available in the LIS Prosang. The association between antibody level and blood group was further analyzed within this cohort. There was a significantly higher odds of Covid positivity among individuals in the cohort with blood type A or AB compared to blood type O. There was no significant difference in odds of Covid positivity among between phenotypes B compared to blood type O. The quantitative levels of SARS-CoV-2 antibodies were similar in individuals with a positive Covid-19 test regardless of ABO and Rh(D) phenotype. The present cohort study supports the hypothesis that the presence of anti-A antibodies in serum should be considered as a factor more significant than the blood group itself. However, the study showed a similar immune response in individuals with a positive Covid-19 test regardless ABO phenotype.
Objectives: This study aimed to evaluate the prevalence and types of unexpected red cell antibodies in blood donors and blood recipients at a tertiary care hospital in New Delhi, India. … Objectives: This study aimed to evaluate the prevalence and types of unexpected red cell antibodies in blood donors and blood recipients at a tertiary care hospital in New Delhi, India. The focus was on alloimmunization and its potential impact on transfusion safety, especially for preventing hemolytic reactions and improving compatibility in transfusion practices. Materials and Methods: A cross-sectional study was conducted at the Regional Blood Transfusion Center of a tertiary care hospital in New Delhi, screening 2500 blood donors and 2500 blood recipients over a 2-month period. Antibody screening was performed using a 3-cell screening panel, with positive cases undergoing detailed clinical history assessment and additional testing with an 11-cell identification panel. Statistical analysis: The association between gender and alloimmunization was assessed using the Chi-square test, with P ≤ 0.05 considered statistically significant. Results: The overall alloimmunization rates were 0.16% in blood donors and 1.08% in blood recipients. Female recipients had a significantly higher alloimmunization rate (1.30%) compared to males (0.27%) ( P = 0.0082). The most commonly identified antibodies were anti-D and anti-E (45.16%), followed by anti-Le a /anti-Le b (16.12%) and anti-M/anti-K (12.9%) each. Among thalassemia patients, the alloimmunization rate was 1.34%. Conclusions: This study highlights the importance of comprehensive pre-transfusion antibody screening, donor phenotyping, and leucodepletion to reduce the risk of alloimmunization and transfusion-related complications. A multifaceted approach combining these strategies can enhance transfusion safety. Further research on the role of leukodepletion in preventing alloimmunization and reducing infection transmission is needed to optimize transfusion practices.
An individual's blood group consists of red blood cell antigens whose composition is determined by protein presence, antigen structure, and gene series. Persons aged above six months have significant anti-A … An individual's blood group consists of red blood cell antigens whose composition is determined by protein presence, antigen structure, and gene series. Persons aged above six months have significant anti-A and/or anti-B in their serum. During transplantation and transfusion, ABO blood group identification is the most essential factor. The conventional method involves drawing blood samples from patients, and the blood group is determined based on the antigen-antibody reaction. This method consists of adding chemical reagents. However, this requires time of operation, and throughput analysis is high, and the process is also challenging to interpret. Accurate and rapid identification of blood groups is therefore crucial in various medical fields, including blood transfusions, organ transplants, and prenatal care. Traditional methods for blood typing often require extensive laboratory equipment and trained personnel, leading to delays and potential errors in critical situations. This research focuses on developing a non-invasive, compact, and user-friendly device capable of determining blood groups quickly without invasively collecting patient’s blood samples and using reagents. The system learns from a database of annotated blood samples by employing machine learning algorithms, enhancing its accuracy and reliability over time. A noninvasive blood group detection system was verified experimentally on a laboratory prototype, achieving an accuracy of 95.9% in identifying blood groups and rhesus factors. Furthermore, a comparative analysis was conducted between the proposed system and existing counterparts. This analysis demonstrated that the proposed system outperforms others in accuracy, indicating the rhesus factor
An individual's blood group consists of red blood cell antigens whose composition is determined by protein presence, antigen structure, and gene series. Persons aged above six months have significant anti-A … An individual's blood group consists of red blood cell antigens whose composition is determined by protein presence, antigen structure, and gene series. Persons aged above six months have significant anti-A and/or anti-B in their serum. During transplantation and transfusion, ABO blood group identification is the most essential factor. The conventional method involves drawing blood samples from patients, and the blood group is determined based on the antigen-antibody reaction. This method consists of adding chemical reagents. However, this requires time of operation, and throughput analysis is high, and the process is also challenging to interpret. Accurate and rapid identification of blood groups is therefore crucial in various medical fields, including blood transfusions, organ transplants, and prenatal care. Traditional methods for blood typing often require extensive laboratory equipment and trained personnel, leading to delays and potential errors in critical situations. This research focuses on developing a non-invasive, compact, and user-friendly device capable of determining blood groups quickly without invasively collecting patient’s blood samples and using reagents. The system learns from a database of annotated blood samples by employing machine learning algorithms, enhancing its accuracy and reliability over time. A non invasive blood group detection system was verified experimentally on a laboratory prototype, achieving an accuracy of 95.9% in identifying blood groups and rhesus factors. Furthermore, a comparative analysis was conducted between the proposed system and existing counterparts. This analysis demonstrated that the proposed system outperforms others in accuracy, indicating the rhesus factor.
Background In human medicine, nucleated red blood cells (NRBCs) in the peripheral blood have been associated with a poor prognosis and increased mortality in critically ill patients. In critically ill … Background In human medicine, nucleated red blood cells (NRBCs) in the peripheral blood have been associated with a poor prognosis and increased mortality in critically ill patients. In critically ill dogs, mortality was also significantly associated with high peripheral NRBC count. Objective This study aimed to determine the presence of NRBCs in the peripheral blood of dogs with regenerative and non-regenerative anemia and to evaluate the prognostic relevance of NRBCs in anemic dogs. Furthermore, the correlation between NRBCs and other blood parameters was examined. Materials and methods Medical records of 254 anemic dogs hospitalized from November 2013 to June 2020 were retrospectively reviewed. Inclusion criteria were a hematocrit of <30%, a minimum age of 6 months, and the presence of a manual blood smear evaluation. Data were analyzed using Fisher’s exact test, Mann–Whitney U test, Kruskal-Wallis test with Dunn’s post-hoc multiple comparison test, and Spearman correlation. p -values <0.05 were considered significant. Results One hundred ninety-one of 254 patients had NRBCs in their blood smear. The absolute NRBC count was significantly higher in dogs with regenerative anemia [1,514/μl (92–40,810/μl)] compared to dogs with non-regenerative anemia [220/μl (10–5,260/μl); p < 0.001]. NRBCs were more often present in dogs with regenerative anemia (141/167) than in dogs with non-regenerative anemia (35/62; p < 0.001). The NRBC concentration was not different between surviving and non-surviving dogs ( p = 0.080). An increase or decrease of NRBCs during hospitalization was also not associated with outcome. Conclusion NRBCs commonly appear in the peripheral blood of dogs with regenerative anemia. Their presence and quantity are not associated with survival.
Abstract Background Some individuals carry a very low expression of the D-antigen, called a Del phenotype. Red cell units from such blood donors with DEL alleles are RhD protein-positive, despite … Abstract Background Some individuals carry a very low expression of the D-antigen, called a Del phenotype. Red cell units from such blood donors with DEL alleles are RhD protein-positive, despite being routinely labelled D-negative. Molecular typing offers a more sensitive method to identify Del individuals by detecting the presence of the RHD gene. Pools of 20 or more donor samples are routinely screened for the RHD gene in some, mostly European, donor populations. Methods A modular real-time PCR assay targeting RHD intron 4, exon 5, and exon 7 was developed for individual testing. We screened for the RHD gene among all blood donors who typed D-negative in routine serology. Results Over 15 years, 2254 D-negative donors were individually tested for the RHD gene. With a sensitivity of detecting 5 RHD positive gDNA copies per reaction, 42 donors tested positive (1.9%). Among them, 34 carried the common RHDΨ allele (80.9%), while 7 harbored 5 known RHD alleles, and 1 a novel RHD deletion. We inadvertently detected 2 other donors with DVI, establishing a population frequency of 1 in 731 for the U.S. Conclusions A modular approach for RHD screening is suitable for blood donors when sample pooling is not feasible among multiethnic donor populations. We transitioned donors since 2009 from serologic D-negative to molecularly RHD -negative status at the NIH Clinical Center. Molecular RHD screening of serologic D-negative donors is an effective way to identify individuals harboring DEL alleles that can cause alloimmunization in transfusion recipients.
Immune-mediated hematologic diseases (IMHD) including immune-mediated hemolytic anemia (IMHA) and immune thrombocytopenia (ITP) can cause severe disease in dogs. The underlying immune system abnormalities associated with these conditions is not … Immune-mediated hematologic diseases (IMHD) including immune-mediated hemolytic anemia (IMHA) and immune thrombocytopenia (ITP) can cause severe disease in dogs. The underlying immune system abnormalities associated with these conditions is not known. The hypotheses of this study were that dogs with IMHD would have increased frequencies of CD4+ and CD8 + lymphocytes, decreased frequencies and numbers of T regulatory cells, and increased frequencies of interleukin (IL)-17 + lymphocytes. Fifteen dogs with newly diagnosed IMHA or ITP and 15 healthy control dogs were recruited for this prospective study. Flow cytometry was used to enumerate CD4 + lymphocytes, CD8 + lymphocytes, T regulatory (CD4 + CD25 + Foxp3+) cells, and lymphocytes secreting IL-17 in dogs with IMHD at diagnosis, then 2 and 4 days after starting immunosuppressive treatment. Median proportion of CD4+ (Day 0: 3.4%, Day 2: 3.3%) and CD8+ (Day 0: 1%, Day 2: 0.6%) cells was lower in dogs with IMHD compared to control dogs (CD4 + 22.8%, CD8 + : 13.6%; P < 0.0001 for each). Additionally, T regulatory cells were reduced in IMHD dogs at Day 0 (0.2% versus 0.6% of total lymphocytes, P = 0.0025). Dogs with IMHD had a higher proportion of lymphocytes positive for IL-17 at Day 2 (1.3%) compared to control dogs (0.4%, P = 0.0024). Dogs with IMHD have immune system alterations at diagnosis and during early treatment characterized by a deficiency in T regulatory cells and an increase in IL-17 + lymphocyte. These changes might contribute to the pathogenesis of IMHA and ITP.
In transfusion medicine, the Du antigen a variation of the RhD antigen is crucial because of its implications for transfusion reactions and haemolytic disease of the foetus and newborn (HDFN). … In transfusion medicine, the Du antigen a variation of the RhD antigen is crucial because of its implications for transfusion reactions and haemolytic disease of the foetus and newborn (HDFN). The Du antigen is clinically significant, but its prevalence in many areas, including Nigeria, is still poorly understood, which presents problems for Rh typing accuracy and transfusion safety. This study aims to determine the proportion of RhD-negative blood donors and the prevalence of the Du antigen among these donors at the University College Hospital (UCH), Ibadan. This cross-sectional study was carried out at UCH, Ibadan and included 50 RhD-negative blood donors. Standard serological procedures were used to obtain blood samples and test them for the Du antigen. Demographic data, including age, gender, and ethnicity, were evaluated alongside serological results. A statistically significant correlation was established between donor age and the prevalence of the Du antigen, whereas no significant correlations were detected with gender or ethnicity. All individuals were confirmed to be RhD-negative, with 6% testing positive for the Du antigen. The results emphasize the necessity for tailored age-specific donor techniques to improve transfusion procedures and guarantee optimal clinical outcomes. Routine Du antigen testing among RhD-negative blood donors is crucial for correct Rh typing and transfusion safety.
Kell blood group is the third in ranking of clinical significance after the ABO and Rh blood group system. Kell blood group (K) antibodies are clinically significant enough to cause … Kell blood group is the third in ranking of clinical significance after the ABO and Rh blood group system. Kell blood group (K) antibodies are clinically significant enough to cause Haemolytic Transfusion Reaction (HTR) and Haemolytic Disease of the Foetus and New-born (HDFN). The aim of the study was to determine the frequency occurrence and percentage distribution of Kell blood group antigens amongst indigenes of Ikwerre ethnicity in Rivers State, Nigeria. This study was a cross-sectional study carried out amongst the Ikwerres whose first generational parental origin is Ikwerre. A total number of two hundred and six (206) subjects consisting of one-hundred males (100) and one-hundred and six females (106) within the age bracket of 18 - 40 years were recruited for the study. Blood samples were collected using standard venipuncture technique into individualized EDTA sample container. Sample analysis was carried out at the Haematology Laboratory of Prof. Nimi Briggs Hospital, Rivers State University, Port Harcourt. All subjects were recruited for three days and their blood samples were taken on their respective days being the 19th, 20th and 25th day of November, 2024 and analysis carried out within 24hours of sample collection. Presence of Kell blood group antigen (K) was carried out using Anti - Kell Monoclonal, Lorne Laboratories Ltd, UK, Lot Number: 760108-B2, Expiry Date: 2026-07-30. Phenotyping was done using the tube technique as described by Lorne Laboratories Ltd, UK. The result showed a total of four (4) positive cases of Kell antigen in only Females and none in males, as well as a percentage distribution of 1.9 % in Females. This finding therefore revealed the rarity of Kell blood group antigen amongst the Ikwerres.
Introducción: Las infecciones por VPH son responsables de lesiones benignas como los condilomas acuminados en pie, manos, anogenitales o lesiones premalignas, diversos tipos de cáncer, como el cervicouterino, vaginal, vulvar, … Introducción: Las infecciones por VPH son responsables de lesiones benignas como los condilomas acuminados en pie, manos, anogenitales o lesiones premalignas, diversos tipos de cáncer, como el cervicouterino, vaginal, vulvar, anal, orofaringeo y pene. Para prevenir su contagio y transmisión se ha incorporado la vacunación contra el VPH en menores de 15 años, sin embargo, su incorporación ha sido condicionada por motivos económicos, creencias culturales, religiosas, edad, sexo entre otras. Objetivo: Reflexionar sobre las barreras que interfieren en la adherencia a la vacunación de hombres contra el VPH. Material y método: Se realizó una revisión narrativa en bases de datos PubMed, WoS y búsqueda manual en Google Scholar en los últimos cinco años usando los descriptores, “Human Papillomavirus” y “Ethic*”. Conclusión: Las barreras identificadas están relacionadas con el principio de justicia, que limita el acceso universal a las vacunas, responsabilizando a las mujeres por el incumplimiento de metas de salud pública. Se requiere implementar actividades educativas para corregir creencias erróneas y reducir el rechazo a la vacunación, involucrando también a los hombres para alcanzar la inmunización en rebaño. Es necesario realizar más investigaciones para incluir a preadolescentes varones como a grupos de alto riesgo en los programas de vacunación. Las actividades educativas deben enfocarse en el contagio del VPH, no solo en el cáncer cervicouterino, con la colaboración de trabajadores sanitarios en conjunto con entidades comunitarias para garantizar la participación de toda la población en los programas de inmunización.
Bombay blood group is a rare blood phenotype, frequently misinterpreted as “O” blood group, and sometime causes severe hemolytic transfusion reactions. We are reporting a 4-year-old cardiac patient with congenital … Bombay blood group is a rare blood phenotype, frequently misinterpreted as “O” blood group, and sometime causes severe hemolytic transfusion reactions. We are reporting a 4-year-old cardiac patient with congenital heart disease. During routine intraoperative evaluation, the patient was confirmed as having Bombay blood group and leukocyte adhesion deficiency type II. As this condition is extremely rare in Saudi Arabia, matched blood donors were secured from outside the country. The patient underwent bilateral peripheral artery stenosis reconstruction. Successful intraoperative management was done using one unit of matched blood transfusion, acute normovolemic hemodilution strategy, intravenous injection of antifibrinolytic agents, and regular antimicrobial surgical prophylaxis. The postoperative period was uneventful, and the patient was discharged from the hospital 1 week later. Correct and preoperative identification of Bombay phenotype, patient labeling and flagging, maintaining records for rare blood groups, and collaborations with other blood banks are necessary strategies for safe management of patients with Bombay blood group.
Autoimmune hemolytic anemia (AIHA) in pregnancy is uncommon and intractable when it becomes steroid-refractory. Due to lacking well-established guidelines for AIHA in pregnancy, a balance must be weighed between benefits … Autoimmune hemolytic anemia (AIHA) in pregnancy is uncommon and intractable when it becomes steroid-refractory. Due to lacking well-established guidelines for AIHA in pregnancy, a balance must be weighed between benefits and risks. It is unlikely to undergo clinical trials to investigate the obstetric outcomes of treatments that may have potential toxicities to the fetus. Therefore, observational cases play a critical role in accumulating experience for this minor population. In this report, we describe a pregnant with a history of AIHA for 10 years. The hemolysis was exacerbated during gestation with very severe anemia and increasing splenomegaly, showing no response to glucocorticoid, immunoglobulin, rituximab and high-dose cyclophosphamide. The patient underwent a successful splenectomy and delivered a normal neonate except for low weight. In the follow-up of 2 years, the underlying disease emerged as systemic lupus erythematosus, and the child grew up healthily with a routine immunization schedule.
Erinca Horian , Leni Lismayanti , Adhi Kristianto Sugianli | INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY
Patients with thalassemia, chronic kidney disease, hematologic and non-hematologic malignancies may require repeated transfusions. Repeated transfusions can have a detrimental effect, leading to the formation of alloantibodies and/or autoantibodies. These … Patients with thalassemia, chronic kidney disease, hematologic and non-hematologic malignancies may require repeated transfusions. Repeated transfusions can have a detrimental effect, leading to the formation of alloantibodies and/or autoantibodies. These antibodies can cause incompatible crossmatch results. This study aims to identify the clinical characteristics of patients with incompatible crossmatch results after repeated transfusions, to ensure safe transfusions. This study is a cross-sectional, observational descriptive study conducted at Dr. Hasan Sadikin General Hospital from January to December 2022. Patients were included if they had received more than one transfusion within the past year, defined as 'repeated transfusions'. The following data were collected: age, gender, blood type, diagnosis, quantity of blood bags, total number of transfusions, interval between transfusions, history of incompatibility, and Coombs Test. The data were obtained through the laboratory information system and from blood request forms in the Blood Service Unit. Out of 2285 subjects receiving repeated transfusions, 38.1% experienced crossmatch incompatibility. The majority (91.2%) of these cases were minor. Crossmatch incompatibility occurred more frequently in subjects under the age of 15 (22.6-23.3%) and those with diagnosis of thalassemia (25.6-27.3%). Most subjects with minor crossmatch incompatibility had a history of receiving more than four blood bags (51.9-60%), an interval between transfusions of four weeks or less (92.2-92.8%), and a history of previous incompatibility (72.1-80.5%). The important clinical characteristics of patients with incompatible crossmatch results after repeated transfusions were age, underlying diagnosis, quantity of blood bags, interval between transfusions, and history of previous crossmatch incompatibility.
Introduction and Objective: Genetic association studies report lower A1C levels with G6PD deficiency (G6PD-D). A1C is used as a diagnostic test for abnormal glucose tolerance (AbnlGT), a summary term for … Introduction and Objective: Genetic association studies report lower A1C levels with G6PD deficiency (G6PD-D). A1C is used as a diagnostic test for abnormal glucose tolerance (AbnlGT), a summary term for diabetes and prediabetes. It is critical to assess the clinical impact of G6PD-D on the diagnostic efficacy of A1C in populations in whom deficiency variants are common and risk of AbnlGT is high, such as Africans. G6PD-D is X-linked and caused primarily by the G6PD A- haplotype in Africa. G6PD-D can be assessed by either genotyping or clinical assay. We determined: 1) the ability of A1C to detect AbnlGT by G6PD-D status; 2) concordance of genotyping and the clinical assay in 506 African-born Blacks enrolled in the Africans in America study (men: 61% (308/506). Methods: AbnlGT was diagnosed by the OGTT. G6PD-D was assessed by genotype only (n=263), genotype and assay (n=188) or assay only (n=55). G6PD-D clinical assay used qualitative visual fluorescence screening in whole blood. A1C ≥5.7% was the threshold for AbnlGT. Results: G6PD-D status was indeterminant in 13 women who were heterozygous for G6PD A- and did not have the assay. In the remaining 493 participants, AbnlGT occurred in 41% (201/493) and G6PD-D in 10% (51/493). G6PD-D prevalence in men and women were: 14% (43/308) v 4% (8/185) P<.001. A1C levels with and without G6PD-D were: 4.6 ± 0.5, (range 3.1 - 5.6) v 5.5 ± 0.6 (range 4.2 - 11.3), P<.001). With G6PD-D, A1C sensitivity and specificity for AbnlGT detection were: 0% (0/16) and 100% (35/35), resp. Without G6PD-D, A1C sensitivity and specificity were: 50% (93/185) and 79% (202/257), resp. Participants with both genotyping and the assay (n=188), concordance for G6PD-D detection was 100%. Conclusion: G6PD-D lowered A1C levels by 0.9%. These falsely low A1C levels could lead to late diagnosis of AbnlGT and complications. Overall, as the assay can detect deficiency in women heterozygous for G6PD A-, the assay for G6PD was more informative than genotyping. Disclosure A.R. Bentley: None. K. Ntabadde: None. K. Balahali: None. K. Ekoru: None. C. DuBose: None. D.B. Sacks: Other Relationship; Sebia, Trinity. A.A. Adeyemo: None. C.N. Rotimi: None. A.E. Sumner: None.
Abstract Background Anti-M antibodies are a group of frequently detected, naturally occurring antibodies, most of which are immunoglobulin M (IgM) antibodies, inactive at 37 °C, and clinically insignificant in blood … Abstract Background Anti-M antibodies are a group of frequently detected, naturally occurring antibodies, most of which are immunoglobulin M (IgM) antibodies, inactive at 37 °C, and clinically insignificant in blood transfusion experiments, except for their effect on blood groups. Anti-M antibodies may be clinically significant in some exceptional cases, however, such as cardiac surgery, when the core body temperature drops, resulting in hemolytic transfusion reactions. The present study was conducted to explore the interference caused by the presence of anti-M antibodies on blood group identification, analyze the necessity of detecting such antibodies in advance for transfusion compatibility testing and clinical transfusion, and explore the importance of O-antigen erythrocytes in routine blood typing, especially in screening for IgM-class antibodies. Methods This study was initiated by collecting blood typing specimens from January 2021 to December 2023 in the Blood Transfusion Department, where the O cell control tubes showed agglutination in the blood group reverse serotyping, which were ultimately determined to be influenced by the anti-M antibodies. This study further analyzed the absorption of plasma using M antigen–positive type O erythrocytes, followed by repeat ABO typing with either the absorbed plasma or standard reverse grouping erythrocytes without M antigen. Our subsequent steps included a cross-matching test with manual tube testing, the Polybrene method, and antiglobulin test, monitoring of the hemoglobin value after transfusion. Results A total of 11 patients had anti-M antibodies detected in their serum. Among these 11 patients, 9 had blood type discrepancies identified during blood typing, and the other 2 cases were identified as type O. We saw 4 cases of IgM-type antibodies, 1 case of IgG-type antibodies, and 7 cases of IgM-type and IgG-type antibodies. The forward and reverse typing of 9 samples showed consistent results after serum reverse typing was rechecked by O cell absorption. Cross-matching was compatible with blood donors without M antigen, and 7 of these patients were treated with transfusion, all of whom had elevated hemoglobin levels after transfusion, with no adverse transfusion reactions. Discussion In specimens with irregular anti-M antibodies, serum absorption can be used to eliminate the interference caused by the irregular antibodies and obtain the correct experimental results. Moreover, the addition of type O red blood cells in the experiment can improve the detection rate of partial antibodies. For specific patients, such as individuals undergoing surgery, regardless of whether the antibody reacts at 37 °C, we recommend choosing M antigen–negative donors for blood transfusion to ensure the safety of blood transfusion for patients in clinical settings.
Background/Objectives: The COVID-19 pandemic has highlighted the importance of identifying factors influencing disease susceptibility and severity. This study investigates the association of ABO blood groups, the D antigen, and comorbidities … Background/Objectives: The COVID-19 pandemic has highlighted the importance of identifying factors influencing disease susceptibility and severity. This study investigates the association of ABO blood groups, the D antigen, and comorbidities such as hypertension and diabetes with COVID-19 severity among hospitalized patients in one Croatian center. Methods: A retrospective observational study was performed on 1687 moderately and severely ill COVID-19 patients and 7086 voluntary blood donors. We used medical records from PCR-confirmed COVID-19 patients hospitalized at University Hospital Center Osijek in Osijek, Croatia, and compared their ABO, RhD, and comorbidity profiles with those of voluntary blood donors. Key clinical data and outcomes, such as mortality and comorbidities, were assessed. Results: Our findings reveal a statistically significant association between blood group A and severe COVID-19 outcome and mortality. Conversely, D antigen status showed no significant impact. The combined presence of hypertension and diabetes emerged as a significant predictor of mortality. Conclusions: These results suggest that blood group A and specific comorbidities may be associated with worse outcomes, but age remained the strongest independent predictor of mortality. Blood group typing could still support risk stratification when interpreted alongside other clinical factors.
Background Anti-D is usually alloimmune and develops in exposed RhD-negative individuals with potential for haemolytic disease of the fetus and newborn (HDFN). However, autoimmune anti-D is rare with limited understanding … Background Anti-D is usually alloimmune and develops in exposed RhD-negative individuals with potential for haemolytic disease of the fetus and newborn (HDFN). However, autoimmune anti-D is rare with limited understanding of its haemolytic risk to the fetus and mother. Case report A 30-year-old woman previously typed as B RhD positive was found to have an autoimmune anti-D on antenatal screening in her third pregnancy. RHD genotyping confirmed RhD positivity without D variants. Anti-D titres remained elevated at 1:512 throughout pregnancy with normal Doppler monitoring and no maternal haemolysis. The neonate was born at 38 weeks and 3 days of gestation with no evidence of haemolysis. Conclusion Autoimmune anti-D in pregnancy is rare and requires a multidisciplinary approach to management. Strategies include RHD genotyping to exclude D variants, close monitoring for HDFN, and careful selection of Rh phenotype matched blood for transfusion if required to avoid alloimmunisation for future pregnancies.
Abstract Adaptive sampling (AS), a computational enrichment method developed for Oxford Nanopore Technologies sequencing platforms, offers a promising advance in molecular blood group diagnostics. By leveraging long-read sequencing, AS has … Abstract Adaptive sampling (AS), a computational enrichment method developed for Oxford Nanopore Technologies sequencing platforms, offers a promising advance in molecular blood group diagnostics. By leveraging long-read sequencing, AS has the potential to accurately resolve complex structural variants in the RH and MNS blood group systems, while characterizing the entire blood group genome. In this study, we evaluated the performance of AS using five samples with known or suspected complex variants in the RH and MNS systems, unresolved by standard methods in immunohematology. Samples were sequenced on a PromethION P2 Solo with up to two samples per flowcell, generating 37.0-52.4 Gb of data with mean on-target coverages of 18.9-53.4x, allowing reliable variant detection. Hybrid alleles were characterized using a de novo assembly approach, whereas variants in non-recombinant regions were analyzed using both a custom in-house and the EPI2ME reference-based workflow. Considering solely exonic variation, 10-15% of detected alleles contained novel nonsynonymous single nucleotide variants (SNVs) or unreported SNV combinations. All suspected hybrid alleles were successfully assembled and identified as GYP*401.02, RHD*03N.01 , and RHD*01EL.44 , representing the first fully characterized haplotypes for these variants publicly available. Overall, AS showed significant potential for advancing blood group genomics by enabling high-resolution, full-gene analysis. Its ability to support high-throughput donor genotyping and precise patient-donor matching may reduce the risk of alloimmunization and delayed hemolytic transfusion reactions, particularly in chronically transfused patients. These findings highlight AS as a powerful tool for both research and clinical applications in transfusion medicine.
Malaria is a global health risk with unpredictable clinical manifestations based on host genetic factors, including ABO blood groups. This systematic review reviews the association between ABO blood types and … Malaria is a global health risk with unpredictable clinical manifestations based on host genetic factors, including ABO blood groups. This systematic review reviews the association between ABO blood types and susceptibility, severity, and haematological complications of malaria. Systematic analysis of 10 studies between the years 2009 and 2025 was conducted using data from PubMed, Scopus, CDC publications, and Malaria Journal. The criterion for inclusion was studies that assessed the relationship between malaria outcomes and ABO blood group types. Unsystematic studies and unrelated studies were not included. The findings indicate that there is a recurring pattern of association between ABO blood groups and malaria severity. Group O blood was most frequently correlated with less severity of disease, while groups A and B were found to be riskier for severe complications including anaemia, hyperbilirubinemia, and increased parasitaemia. Several studies by Animagi et al. and Haftu Asmerom noted significantly higher odds of severe cases among group A individuals. experimental studies have provided a biological explanation, suggesting that individuals with blood group O exhibit reduced rosetting and lower erythrocyte invasion rates, which may contribute to their relative protection, These findings are relevant to clinical and public health. Identification of high-risk blood group can improve risk stratification, guide early treatment, and inform malaria control policy in endemic areas. Blood group data incorporation into diagnostic protocols and malaria management could also improve outcomes, especially in resource-constrained settings. ABO blood groups significantly influence the susceptibility and severity of malaria. Group O corresponds to relative protection, while group A and group B correspond to augmented disease burden. The addition of blood group screening to the protocols of care for malaria would improve patient outcome and direct further research on host-pathogen interaction.