Other blood groups , COLD reacting antibodies

Lewis blood group

Produced by tissue and secreted into body fluids

Absorbed onto RBCs

Lewis gene

Le or le, Antigens Lea and Leb

If you have Le you produce Lea

Lewis Lea Leb production

Produced regardless of H and Se

Leb = requires H, Le, and Se to be present

90% whites posses Le gene

Lewis during pregnancy

May slough off

Moms can make Antibody to Lewis antigens

Not developed on fetal cells = NO HDFN

Lewis antibodies

Generally produced by Lea-b- individuals

IgM naturally occuring

React at 37/AHG, insignificant

Enhanced by enzymes

Lewis disease association

H pylori, uses Leb to enter cells of stomach lining leading to peptic ulcers

I blood group

Cold agglutinin

I found in adults

i found in infants = gradually become I positive over time, some never convert

anti-I

Commonly weak autoantibodies

IgM naturally occuring

React at 4C in saline = strong in adults, weak in infants

Reaction enhanced w/ enzymes/cold

i and IH antibodies

Anti-i is rare autoantibody

Reacts strongly with cord (fetal) cells

IgM reacts 4C

Anti-IH = compound antigen, rare/most common in group A

Cold antibodies

Must get rid of to identify significant alloantibodies

Pre-warm techniques = warm plasma, if goes away then not significant

Cold antibodies diseases

Mycoplasma pneumoniae = I like anigen, auto anti-I, High titers = RBC destruction

Infectious mononucleosis = i like antigen, produces an auto anti-i

P-P1PK and GLOB

P1PK = P1, Pk and NOR

GLOB = P and PX2

P1 = poorly developed at birth

P antigen = developed at birth

Anti-P1

Naturally occuring IgM

Seen in P2 individuals

Enhanced with enzymes

Reactivity neutralized with hydatid cyst fluid or pigeon eggs = P1 substance

NO HDFN

Reacts in cold w/ saline, Rare can react 37C = HTR

Anti-P

Found in Pk individuals

IgM hemolysin = HTR

IgG = spontaneous abortion

Autoanti-P; PCH

Autoanti-P, PCH

Paroxysmal cold hemoglobulinuria

Donath Landsteiner syndrome

Biphasic = attaches in cold, lyses when warm

Anti-PP1PK

Produced by p individuals, IgG/IgM

Wide thermal range

Binds complement

HTR / Spontaneous abortion

MNSs

GYPA

GYPB

Developed at birth

U high frequency

GYPA

Produces glycophorin A on RBC

Carries M and N antigens

MNSs

GYPB

Produces gylcophorin B on RBC

Carries S and s antigens

If S+ or s+ = U is present

MNSs

Anti-M

Cold reacting IgM / IgG

Destroyed by enzymes

Do not bind complement

Shows dosage

Rare 37C/AHG

Anti-N

Uncommon

Similar to M

Destroyed by enzymes

Shows dosage

Rarely clinically significant

Anti-S and anti-s

IgG

37C/AHG reactive

Enzyme variable

Rarer than M, more significant

Seen in HTR and HDN

Binds complement

Anti-U

High frequency antigen, antibodies are rare

HTLA

High titer, low avidity antibodies

IgG

Transfusion pregnancy, clinically insignificant

React variably/ weakly

Titer greater than 64