الفهرس 
COVEROnly 14 pages are availabe for public view
 |  | from | 195 |  |  |
| | | from | 195 | | |
Abstract
RBCs alloimmunization associated with autoimmune hemolytic anemia is a recognized complication of blood transfusion in multi-transfused patients. An auto antibody in the patient’s serum will generally react with all RBCs tested including their own, thus making it impossible to find compatible blood. Traditionally, several blood banks have the policy of crossmatching and issuing blood that is either least incompatible or as compatible as the patient’s own RBCs, however this is considered an unacceptable practice because of the probability of masking the presence of a potentially hemolytic alloantibody.
This study was designed to detect the prevalence and specificity of red cell alloantibodies underlying pan reactive autoantibodies in multi-transfused Egyptian patients.
A total of 60 multi-transfused Egyptian patients with autoimmune hemolytic anemia were studied. Patients studied were 26 (43.3 %) male and 34 (56.7 %) female with a male to female ratio 1: 1.3. Their age ranged from 30 to 65 years; (mean ± SD, 49.3 ± 10.1 years). In addition, 20 age and sex matched subjects who received single blood transfusion were included as control group.
The initial antibody screening and identification, direct antiglobulin test and auto-control were done for all studied groups (patients and control) and their results were positive in all studied patients with AIHA. Immediate spin was done to determine the type of autoantibodies. Antibody screening using pre-warming technique was done in cases with cold autoantibodies. Allogenic adsorptions with R1R1, R2R2 and rr cells, complementary lacking the clinically significant antigens, were used to remove auto antibodies from the patient’s serum in patients with warm autoantibodies. After adsorption, adsorped sera were tested to detect and identify possible underlying alloantibodies, using commercial reagent red cells (Ortho-Clinical Diagnostics) by CAT (Ortho-BioVue System Poly cassettes).
Out of 60 samples, 5 patients (8.3%) with cold auto-antibodies were identified with absence of underlying allo-antibodies. In 55 patients with warm auto-antibodies, 23(41.8%) patients with a total number of 40 underlying allo-antibodies were detected.
Regarding the specificity of alloantibodies detected in the present study, anti-E (22.5%) and anti-Kell (15%) antibodies were found to be the most frequent. The development of alloantibodies was also found, in the present study, to be significantly associated with frequency of blood transfusion, leucodepleted blood and splenectomy.
On the other hand, no statistical significance was found regarding the incidence of alloimmunization among some of the studied parameters in patients group including age, sex, cause of anemia, patient’s blood group or phenotype.