50 research outputs found
Effects of Red-Cell Storage Duration on Patients Undergoing Cardiac Surgery
Some observational studies have reported that transfusion of red-cell units that have been stored for more than 2 to 3 weeks is associated with serious, even fatal, adverse events. Patients undergoingcardiac surgery may be especially vulnerable to the adverse effects of transfusion
Brown Recluse spider bite mediated hemolysis: clinical features, a possible role for complement inhibitor therapy, and reduced RBC surface glycophorin A as a potential biomarker of venom exposure.
The venom of Loxosceles reclusa (Brown Recluse spider) can cause a severe, life-threatening hemolysis in humans for which no therapy is currently available in the USA beyond supportive measures. Because this hemolysis is uncommon, relatively little is known about its clinical manifestation, diagnosis, or management. Here, we aimed to clarify the clinical details of envenomation, to determine the efficacy of the complement inhibitor eculizumab to prevent the hemolysis in vitro, and to investigate markers of exposure to Brown Recluse venom.We performed a 10-year chart review of cases of Brown Recluse spider bite-mediated hemolysis at our institution. We also designed an in vitro assay to test the efficacy of eculizumab to inhibit hemolysis of venom exposed red blood cells. Finally, we compared levels of CD55, CD59 and glycophorin A on venom exposed versus venom-naĂ¯ve cells.Most victims of severe Brown Recluse spider mediated hemolysis at our institution are children and follow an unpredictable clinical course. Brown Recluse spider bite mediated hemolysis is reduced by 79.2% (SD=18.8%) by eculizumab in vitro. Erythrocyte glycophorin A, but not CD55 or CD59, is reduced after red blood cells are incubated with venom in vitro.Taken together, our laboratory data and clinical observations indicate that L. reclusa venom exposure results in non-specific antibody and complement fixation on red blood cells, resulting in complement mediated hemolysis that is curtailed by the complement inhibitor eculizumab in vitro. Glycophorin A measurement by flow cytometry may help to identify victims of L. reclusa envenomation
Photographs of plasma under various experimental conditions after 72 hours of incubation, compared to initial plasma (right).
<p>Photographs of plasma under various experimental conditions after 72 hours of incubation, compared to initial plasma (right).</p
Top Row: Mean data from 5 experiments show that venom exposure results in a statistically insignificant alteration in the expression of CD 55 (A) and CD 59 (B), but a statistically significant reduction of glycophorin A (C). Error bars indicate +/- 1 standard deviation. Bottom Row: Representative histograms from a single experiment (Red = untreated cells; Blue = PBS treated cells; Orange = venom treated cells; Green = isotype control).
<p>Top Row: Mean data from 5 experiments show that venom exposure results in a statistically insignificant alteration in the expression of CD 55 (A) and CD 59 (B), but a statistically significant reduction of glycophorin A (C). Error bars indicate +/- 1 standard deviation. Bottom Row: Representative histograms from a single experiment (Red = untreated cells; Blue = PBS treated cells; Orange = venom treated cells; Green = isotype control).</p