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A cold scare: Formation of cold reactive anti-A1 coinciding with gross hemolysis
Anti-A(1) antibodies can be found as a usually clinically insignificant naturally occurring cold IgM antibody in A-subgroup patients. It is known from multiple prior case reports that warm-reactive anti-A(1) that reacts at 37 °C can be clinically significant, and it has been previously reported that...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6041429/ https://www.ncbi.nlm.nih.gov/pubmed/30009243 http://dx.doi.org/10.1016/j.plabm.2018.e00100 |
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author | Petersen, Jeffrey Jhala, Darshana |
author_facet | Petersen, Jeffrey Jhala, Darshana |
author_sort | Petersen, Jeffrey |
collection | PubMed |
description | Anti-A(1) antibodies can be found as a usually clinically insignificant naturally occurring cold IgM antibody in A-subgroup patients. It is known from multiple prior case reports that warm-reactive anti-A(1) that reacts at 37 °C can be clinically significant, and it has been previously reported that it could form after alloimmunization with donor A(1) red blood cell (RBC) transfusion. In addition, the development of anti-A(1), often as an autoantibody, have been described in the setting of various malignancies, perhaps due to expressed subtle alterations of the ABO antigens provoking an immune response. Here, we report a rare case of a cold-reactive anti-A(1) alloantibody (after multiple transfusions with group A(1) RBC units) in a 76 year old male patient (A(2)) with history of myelodysplastic syndrome and metastatic carcinoma who presented with hemolytic anemia and dark urine. The patient had previously typed as blood type A without reverse typing reaction for anti-A(1); as a result, the patient had been transfused with group A(1) RBCs. Four days prior to discovery of the ABO discrepancy, the patient had a febrile transfusion reaction associated with his A(1) RBC transfusion. On admission, his immunohematology workup demonstrated an alloantibody to anti-A(1) that coincidentally appeared during a new onset of hemolytic anemia. Case reports of patients with hemolytic anemia with a newly developed anti-A(1) alloantibody are sparse in the literature, and this case is particularly interesting as the cold reactive anti-A(1) (without demonstrable wide thermal amplitude) appeared to form after alloimmunization and in the setting of an underlying malignancy. |
format | Online Article Text |
id | pubmed-6041429 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-60414292018-07-13 A cold scare: Formation of cold reactive anti-A1 coinciding with gross hemolysis Petersen, Jeffrey Jhala, Darshana Pract Lab Med Article Anti-A(1) antibodies can be found as a usually clinically insignificant naturally occurring cold IgM antibody in A-subgroup patients. It is known from multiple prior case reports that warm-reactive anti-A(1) that reacts at 37 °C can be clinically significant, and it has been previously reported that it could form after alloimmunization with donor A(1) red blood cell (RBC) transfusion. In addition, the development of anti-A(1), often as an autoantibody, have been described in the setting of various malignancies, perhaps due to expressed subtle alterations of the ABO antigens provoking an immune response. Here, we report a rare case of a cold-reactive anti-A(1) alloantibody (after multiple transfusions with group A(1) RBC units) in a 76 year old male patient (A(2)) with history of myelodysplastic syndrome and metastatic carcinoma who presented with hemolytic anemia and dark urine. The patient had previously typed as blood type A without reverse typing reaction for anti-A(1); as a result, the patient had been transfused with group A(1) RBCs. Four days prior to discovery of the ABO discrepancy, the patient had a febrile transfusion reaction associated with his A(1) RBC transfusion. On admission, his immunohematology workup demonstrated an alloantibody to anti-A(1) that coincidentally appeared during a new onset of hemolytic anemia. Case reports of patients with hemolytic anemia with a newly developed anti-A(1) alloantibody are sparse in the literature, and this case is particularly interesting as the cold reactive anti-A(1) (without demonstrable wide thermal amplitude) appeared to form after alloimmunization and in the setting of an underlying malignancy. Elsevier 2018-05-07 /pmc/articles/PMC6041429/ /pubmed/30009243 http://dx.doi.org/10.1016/j.plabm.2018.e00100 Text en http://creativecommons.org/licenses/by/4.0/ This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Petersen, Jeffrey Jhala, Darshana A cold scare: Formation of cold reactive anti-A1 coinciding with gross hemolysis |
title | A cold scare: Formation of cold reactive anti-A1 coinciding with gross hemolysis |
title_full | A cold scare: Formation of cold reactive anti-A1 coinciding with gross hemolysis |
title_fullStr | A cold scare: Formation of cold reactive anti-A1 coinciding with gross hemolysis |
title_full_unstemmed | A cold scare: Formation of cold reactive anti-A1 coinciding with gross hemolysis |
title_short | A cold scare: Formation of cold reactive anti-A1 coinciding with gross hemolysis |
title_sort | cold scare: formation of cold reactive anti-a1 coinciding with gross hemolysis |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6041429/ https://www.ncbi.nlm.nih.gov/pubmed/30009243 http://dx.doi.org/10.1016/j.plabm.2018.e00100 |
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