immunohematology - antibody detection and ID 1

cold alloantibodies

IgM antibodies that react during IS crossmatching and sometimes at 27C, not clinically significant

autoantibodies

react with all reagents and self and donor RBCs, regardless of antigens present, autocontrol and DAT are also pos

adsorption

_____ techniques are usually performed to remove autoantibodies

cold autoantibodies

react during IS crossmatching and have a positive autocontrol and DAT

cold autoantibodies

may occur in patients with a history of mild anemia, mycoplasma pneumoniae, or infectious mononucleosis

anti-I, anti-H, anti-IH

most cold autoantibodies are _____, cold panels can aid in identifying them

anti-P1, anti-M, anti-N

cold alloantibodies that have variable reactions

hemolytic anemia

cold autoantibodies may cause autoimmune _____

auto-anti-I

most normal and healthy individuals have cold _____ in their plasma, which is benign

cold agglutinin syndrome 

idiopathic cause, peak incidence of >50 years, rarely severe, occurs in winter

auto-anti-I

cold agglutinin syndrome antibody that is secondary to mycoplasma pneumoniae

auto-anti-i

cold agglutinin syndrome antibody that is secondary to infectious mononucleosis

acrocyanosis

symptom of cold agglutinin syndrome that is blueness of extremities

cold agglutinin syndrome

cold agglutinin activates in skin capillaries, causes blood stasis, binds complement, returns to warm areas and antibody detaches leaving complement, complement bound cells removed by phagocytes

cold agglutinin syndrome

anemia and acrocyanosis, positive DAT with polyspecific AHG (pos with anti-C3d and neg with anti-IgG), titer >1000

auto-anti-P

paroxysmal cold hemoglobinuria (PCH) is caused by _____

paroxysmal cold hemoglobinuria (PCH)

secondary to viral illness in children or syphilis, acute and rapid intravascular hemolysis, titer <64, resolves after infection

auto-anti-P

biphasic IgG antibody that attaches to RBCs and binds complement in cold extremities, elutes off once in warm areas, complement cascade causes rapid intravascular hemolysis

donath landsteiner test

a positive _____ indicates PCH

monospecific

to avoid cold autoantibodies, use _____ IgG AHG reagent rather than polyspecific

22% bovine serum albumin

what could be used instead of LISS to avoid cold autoantibodies?

adsorption

technique to remove specific interfering antibodies from plasma, RBCs are mixed with plasma and act as a sponge to soak up antibodies

warm antibodies

may cause false pos for Rh typing, use low protein anti-D or perform D genotyping to fix

warm autoimmune hemolytic anemia

this may be idiopathic or result of disease or drug, warm antibodies

Rh, RHCE

most warm autoantibodies are directed to the _____ system, especially, _____

elution

used to identify antibodies when the DAT is positive, the IgG must be detached by using elution technique

elution

performed in suspected cases of HDFN and may not be reactive in all cases of warm autoantibodies

adsorption

warm autoantibodies need to be removed to test for underlying alloantibodies, cells are pretreated with zzap to remove any in vivo attached antibodies, the new plasma is tested with the antibody screen or panel

chloroquine diphosphate

treating cells with _____ will dissociate the IgG from the RBCs without harming the antigens