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Prevalence of the Direct Antiglobulin Test and Its Clinical Impact on Multiply Transfused Thalassemia Patients: A Prospective Study Conducted at a Tertiary Care Center in Northern India.

OBJECTIVE: This study was conducted to estimate prevalence of direct antiglobulin test (DAT) positivity and its impact on transfusion support in patients with thalassemia. METHODS: The DAT testing was performed for patients with β-thalassemia who received transfusion from November 2021 to March 2022. Elution was done for DAT-positive samples. RESULTS: Of 180 patients, 21 (11.6%) were DAT positive. Immunoglobulin G (IgG) was present in 4 (19%) and IgG+C3d was present in 8 (38%). Only complement was present in 9 (42.8%) patients. The IgG-reactive DATs were associated with pan-reactive eluate.

DAT negative warm autoimmune haemolytic anaemia secondary to a mature cystic teratoma refractory to immunosuppressive therapy.

Mature cystic teratomas (MCTs) have a rare but recognised association with IgG-mediated autoimmune haemolytic anaemia (AIHA). We present the first case of an MCT associated with IgA-mediated AIHA. We discuss the diagnostic challenges of patients presenting with a direct antiglobulin test negative AIHA picture and the importance of reviewing these cases with the local transfusion laboratory. We also review the treatment options for MCT associated AIHA. In particular, we note they are typically resistant to immunosuppression and that surgical resection should be considered at an early stage. Alt

[Rare blood donors with irregular antibodies].

INTRODUCTION: Blood groups are inherited biological characteristics that do not change throughout life in healthy people. Blood groups represent antigens found on the surface of red blood cells. Kell blood group system consists of 31 antigens. Kell antigen (K) is present in 0.2% of the population (the rare blood group). Cellano antigen is present in more than 99% (the high-frequency antigen). These antigens have a distinct ability to cause an immune response in the people after blood transfusion or pregnancy who, otherwise, did not have them before. CASE REPORT: This paper presents a blood do

A neonate with Coombs-negative hemolytic jaundice with spherocytes but normal erythrocyte indices: a rare case of autosomal-recessive hereditary spherocytosis due to alpha-spectrin deficiency.

The diagnosis of hereditary spherocytosis (HS) in a newborn infant is generally made on the basis of a positive family history, spherocytes on blood film and Coombs-negative hemolytic jaundice of variable severity with an elevated mean corpuscular hemoglobin concentration (MCHC) and a low mean corpuscular volume (MCV). In general, sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) quantification of erythrocyte membrane proteins is not needed to make the clinical diagnosis of HS. However, we observed that a neonate with no family history of HS, but with abundant spherocytosis

Management of blood donors and blood donations from individuals found to have a positive direct antiglobulin test.

The medical literature is replete with articles addressing the diagnosis and management of patients with a positive direct antiglobulin test (DAT). However, there is scant information addressing the management of blood donors and blood donations found to have a positive DAT. Practices vary considerably between countries and blood suppliers within countries, and there is no standardized approach to the management of these blood donors or the blood products prepared from their donations. Recent evidence from Israel suggests that the finding of a positive DAT in a blood donor may not be as benign

The evaluation of a positive direct antiglobulin test (autocontrol) in pretransfusion testing revisited.

Direct antiglobulin tests (DATs) using anti-IgG were performed on 65,049 blood samples from prospective transfusion recipients; 3570 tests (5.49%) were positive. Using criteria published previously (primarily excluding patients not transfused within the preceding 14 days), 778 samples from other than neonatal patients were selected for further evaluation. Eluates that did not react were obtained on 518 (66.6%) of these samples. Warm-reactive autoantibodies were apparent in 192 eluates, while 16 contained drug-related antibodies, anti-A or anti-B from prior transfusion with ABO mismatched blood

[Transfusional hemolytic reactions of an alloantibody not determinable by standard methods of compatibility].

Anti-e is rare as allontiboby, relatively frequent as autoantibody. A case of immediate haemolytic transfusion reaction (IHTR) in a patient with a high-titer alloantiboby of this specificity, not revealed in cross-match, is described.

Two Cases of Pancytopenia with Coombs-Negative Hemolytic Anemia after Chimeric Antigen Receptor T-Cell Therapy.

BACKGROUND: Chimeric antigen receptor (CAR) T-cells are changing the therapeutic landscape of hematologic malignancies. Severe side effects include cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS), but prolonged cytopenia has also been reported. The underlying mechanism for prolonged cytopenia is poorly understood so far. CASES: Severe pancytopenia with grade 2-3 anemia was marked 2-3 months after treatment. Laboratory evaluation revealed undetectable levels of haptoglobin with increased reticulocyte counts. Coomb's tests were negative, no sch

Autoimmune hemolytic anemia in treatment-naive chronic hepatitis C infection: a case report and review of literature.

The hepatitis C virus (HCV) is the most common blood-borne pathogen and currently infects over two hundred and fifty million individuals worldwide. Chronic HCV infection may result in cirrhosis, hepatocellular carcinoma, and liver failure. An exceedingly rare extrahepatic manifestation of HCV is autoimmune hemolytic anemia (AIHA). We discuss an interesting case of direct Coombs'-positive AIHA in a treatment-naive 53-year-old male with a past medical history of HCV cirrhosis, genotype 3a, who presented with fatigue, abdominal pain, and jaundice. Complete blood cell count demonstrated anemia, th

Evaluation of a new immunocapture test for the diagnosis of ovine brucellosis caused by Brucella melitensis.

A new immunocapture technique has been applied to the diagnosis of ovine brucellosis under experimental conditions. The tests were made on a serum bank derived from both young and adult ewes vaccinated conjunctivally with the Rev 1 strain at a dose of 10(8) to 10(9) colony-forming units. Adult ewes were infected experimentally two-and-a-half years after they had been vaccinated and the results were compared with an unvaccinated control group. The condition of each animal in terms of infection with Brucella melitensis was determined by clinical and bacteriological investigations. The developmen

Clinical significance of sperm antibodies in infertility.

Sperm antibody (AB) titers, determined by passive hemagglutination and cytotoxicity assays, were found to be elevated in 62 males and 46 females of 103 couples with primary infertility; 15 males and 12 females of 25 couples with secondary infertility; 10 males and 8 females of 18 couples with histories of repeated abortion; 21 males and 17 females of 25 couples in which the husband had a history of prostatitis; and 29 males and 17 females of 38 couples in which the husband had oligospermia. Of the couples in which one or both partners had elevated sperm AB titers, only 4 achieved pregnancy: 3

Isoimmunizations among marmosets to identify leucocyte antigens.

Saguinus fuscicollis ssp., S.o. oedipus, and S. nigricollis marmosets were immunized with white blood cells (WBC) from S.f. illigeri marmosets. Of the three genetic donor-host combinations attempted, only an interspecies immunization of S.o oedipus marmosets resulted in antibody formation which was detectable by agglutination or cytotoxicity tests. Analysis of one of the antisera with a panel of WBC from S.f. illigeri marmosets indicated varying specificities, reactions ranging from strong, intermediate, to completely negative. That the serum was detecting genotypic as well as phenotypic marke

Rare Loxoscelism-Associated IgG Coombs-Positive Hemolytic Anemia Treated Successfully With Systemic Corticosteroids.

Loxoscelism-associated hemolytic anemia is a rare but critical complication of brown recluse spider bites. It may lead to various systemic manifestations, including jaundice, dark urine, and anemia-related symptoms, in addition to general loxoscelism symptoms such as skin lesions, fever, myalgia, nausea, and vomiting. Prompt diagnosis is crucial and requires recognizing typical laboratory findings such as low hemoglobin, elevated lactate dehydrogenase, reduced haptoglobin levels, and possibly a positive direct antiglobulin test. There is no definitive guideline for the treatment of loxoscelism

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… In our case, the combination of low hemoglobin, low haptoglobin, elevated LDH, spherocytes on peripheral blood smear, and IgG-positive Coombs test, all lead to the presumption that RBCs destruction was induced by warm autoimmune hemolytic anemia. …

[Delayed hemolytic reaction to transfusion in sickle cell anemia. Report of one case].

Sickle cell anemia was a rare disease in Chile, especially in adults, however the recent immigration wave from Haiti is changing this scenar … worsening her condition. An alloimmunization and delayed hemolytic reaction was suspected. A direct Coombs test was positive. She was treated with steroids and her serum hemoglobin rose progressively.

Acute Brucellosis Presenting as an Autoimmune Hemolytic Anemia.

Brucellosis is one of the most widespread zoonosis in the world. Hematological complications in brucellosis usually present as mild anemia, leukopenia, or pancytopenia. Autoimmune hemolytic anemia in brucellosis is rarely reported. Here, we report an 18-year-old female presented to us with progressive fatigue, jaundice, and fever. Hematological investigations revealed hemolytic anemia. Direct Coombs test was positive. Further evaluation showed positive serology and culture for Brucella. The patient was diagnosed with brucellosis with autoimmune hemolytic anemia. She was put on rifampicin and d…

Primary biliary cirrhosis associated with mixed type autoimmune hemolytic anemia and sicca syndrome: a case report and review of literature.

A case presenting with an unusual association of primary biliary cirrhosis and mixed type autoimmune hemolytic anemia plus sicca syndrome is described. The 49-yr-old female primary biliary cirrhosis patient had a confirmed sicca syndrome and presented with jaundice and life-threatening anemia. Laboratory tests revealed positive Coombs' test with coexisting cold and warm autoantibodies. She was successfully treated by blood transfusion with packed red cells lacking any red cell antigens corresponding to serum alloantibodies and pulse methylprednisolone therapy. The patient remained stable under