Naturally occurring clinically significant anti-M alloantibodies with wide thermal range: A series of three cases

Anti-M antibodies are usually of the immunoglobulin (Ig)-M type and have a cold thermal range, which is generally considered clinically insignificant. However, in some cases, there may also be an IgG component present exclusively. In addition to the discrepancy in blood grouping (attributable to the IgM component), the presence of an IgG component reacting at 37°C can interfere with pretransfusion testing, making it difficult to find fully compatible blood within a short time. In this report, we discuss three children: two boys aged five and 1½ years, respectively, and a female toddler aged 1 year who were all successfully treated using M-antigen negative packed red blood cells along with the standard treatment plan of the hospital. This was made possible by an established institutional blood donor registry comprising O-typed blood donors (n = 374), who were phenotyped for 21 erythrocyte antigens using commercially available monoclonal antisera (Ortho Clinical Diagnostics, Pvt Ltd., Mumbai, India)

Characterizing “fibrofog”: Subjective appraisal, objective performance, and task-related brain activity during a working memory task

The subjective experience of cognitive dysfunction (“fibrofog”) is common in fibromyalgia. This study investigated the relation between subjective appraisal of cognitive function, objective cognitive task performance, and brain activity during a cognitive task using functional magnetic resonance imaging (fMRI). Sixteen fibromyalgia patients and 13 healthy pain-free controls completed a battery of questionnaires, including the Multiple Ability Self-Report Questionnaire (MASQ), a measure of self-perceived cognitive difficulties. Participants were evaluated for working memory performance using a modified N-back working memory task while undergoing Blood Oxygen Level Dependent (BOLD) fMRI measurements. Fibromyalgia patients and controls did not differ in working memory performance. Subjective appraisal of cognitive function was associated with better performance (accuracy) on the working memory task in healthy controls but not in fibromyalgia patients. In fibromyalgia patients, increased perceived cognitive difficulty was positively correlated with the severity of their symptoms. BOLD response during the working memory task did not differ between the groups. BOLD response correlated with task accuracy in control subjects but not in fibromyalgia patients. Increased subjective cognitive impairment correlated with decreased BOLD response in both groups but in different anatomic regions. In conclusion, “fibrofog” appears to be better characterized by subjective rather than objective impairment. Neurologic correlates of this subjective experience of impairment might be separate from those involved in the performance of cognitive tasks