Accompanying antibodies during immunization tored blood cell antigens

Abstract

Background: Alloantibodies in some patients are accompanied by au-toantibodies. These autoantibodies may react with all red blood cells (RBC),or they may show a partial blood group antigen specificity that is usuallyspecific for the patient’s own antigens. However, discrimination betweenauto- and alloantibodies may be obscure in some cases. Aim: We describe a patient with alloimmunization and accompanyingantibodies that showed characteristics of both allo- and autoantibodies. Methods: Immunohematologic standard methods were used for serologic-and genotyping, antibody differentiation, adsorption and elution. Patient and Results: A 36-year old female, blood group A, ccD.EE, K-,Jk(a-), Fy(a), with liver cell carcinoma was repeatedly transfused because ofsurgical procedures. This patient developed antibodies against C, e, Jk(a)and subsequently Fy(b). In addition, accompanying autoantibodies withoutblood group specificity could be demonstrated by adsorption and elutionusing RBC of the blood group ccD.EE Jk(a-) Fy(b-). The autoantibodies werereactive with RBC of all blood groups. Apart from autoantibodies, additionally anti-C could be adsorbed to and eluted from the ccD.EE Jk(a-)Fy(b-) RBC. Anti-G could be excluded with D-positive RBC. Summary: This case illustrates the potential autoreactivity of newlyformed alloantibodies, a behavior that has sometimes been calledpseudoalloreactive autoantibodies or mimicking type antibodies thatresemble a Matuhasi-Ogata phenomenon. This case also illustrates thecomplexity of immunization that may not only include accompanyingautoantibodies, but also accompanying alloantibodies