Prevalence and laboratorial determinants of the clinical relevance of antibodies of undetermined specificity

Autor:	José Eduardo Krieger, Alfredo Mendrone-Junior, Ester Cerdeira Sabino, Marcia Regina Dezan, Regina A Cardoso, Karen Chinoca Ziza, Abel Costa Neto, V.B. Oliveira, Marina C. A. V. Conrado, Carla Luana Dinardo, Alexandre C. Pereira, Vanderson Rocha
Rok vydání:	2019
Předmět:	Male medicine.medical_specialty Anemia Sickle Cell Disease 030204 cardiovascular system & hematology Gastroenterology Monocytes 03 medical and health sciences 0302 clinical medicine Antibody Specificity Isoantibodies Internal medicine medicine Humans Blood Transfusion Clinical significance Single institution biology business.industry Monocyte Transfusion Reaction Hematology General Medicine Haemolysis medicine.anatomical_structure RH-antibodies biology.protein Antibody business 030215 immunology
Zdroj:	Vox Sanguinis. 114:616-621
ISSN:	1423-0410 0042-9007
DOI:	10.1111/vox.12797
Popis:	Background and objectives Antibodies of unknown specificity (AUS) are frequently identified in the pre-transfusion testing. These antibodies can be insignificant or potentially cause post-transfusion haemolysis. Information about the prevalence of clinically relevant AUS is still lacking. Our aim was to predict the potential clinical relevance of AUS using the monocyte monolayer assay (MMA) and to identify the clinical and laboratorial determinants of AUS' significance. Materials and methods Antibodies of unknown specificity identified at a single institution from 2015-2017 were evaluated through MMA. A monocyte index (MI) of more than 5% was predictive of potential post-transfusion haemolysis. Results Thirty-two patients with AUS were included in the study. Of the studied AUS, 37·5% (12/32) presented with a monocyte index (MI) more than 5%. In the group of significant AUS, 41·7% of the patients presented with sickle cell disease (SCD) and the AUS were associated with Rh antibodies in 75% of the cases. In the group of insignificant AUS, only 10% of the patients had SCD and the association with Rh antibodies was detected in 20% of the cases. The presence of Rh antibodies was independently associated with the AUS clinical relevance (P = 0·012). Conclusion More than one-third of the AUS are potentially clinically relevant, and the association with Rh antibodies is predictive of AUS relevance. Services must honour AUS in the pre-transfusion process in order to ensure transfusion safety.
Databáze:	OpenAIRE
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