Abstract
Background:
Autoantibodies (AAB) to red blood cells (RBC) are a prerequisite for autoimmune hemolytic anemia and may be present in patients that have developed RBC alloantibodies (ALLA) after transfusion or transplantation. It is unknown, whether these patients were primarily auto immunized and developed ALLA, or whether they were primarily not immunized and developed AAB due to the allogenic ...
Abstract
Background:
Autoantibodies (AAB) to red blood cells (RBC) are a prerequisite for autoimmune hemolytic anemia and may be present in patients that have developed RBC alloantibodies (ALLA) after transfusion or transplantation. It is unknown, whether these patients were primarily auto immunized and developed ALLA, or whether they were primarily not immunized and developed AAB due to the allogenic stimulus.
Patients and Methods:
Between August 1998 and June 2006, all in- and outpatients of the Charité University Hospital, Berlin with detectable AAB were included in this study. Serological examination was performed using standard techniques for the detection of RBC antibodies.
Results:
A total of 717 patients were found to have AAB, with ALLA observed in 200 of these patients (28%). The history of antibody production could be evaluated in 98 of the 200 patients: Both AAB and ALLA were due to RBC transfusion in 73 cases (75%), and stem cell transplantation in six cases (6%). The AAB of these 81% were not genuine, but appeared in company of allo-immunization. Nine other patients (9%) were primarily allo-immunized and subsequently developed AAB. The remaining 10 patients (10%) were primarily auto-immunized and later developed ALLA. Six of these patients had “true” autoimmune hemolytic anemia (AIHA).
Conclusion:
The majority of RBC autoimmunizations occurred in a combination with allo-immunization. The development of AAB to RBC is frequently a side-effect of RBC transfusion.
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