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Red cell autoantibodies, multiple immunoglobulin classes, and autoimmune hemolysis
R J Sokol1, S Hewitt, D J Booker
1Regional Blood Transfusion Center, Sheffield, UK.
Transfusion
|October 1, 1990
Summary
Multiple immunoglobulin coating on red blood cells (RBCs), even if undetected by standard tests, significantly causes hemolysis. This indicates a broader autoimmune response contributing to red blood cell destruction.
Area of Science:
- * Immunology
- * Hematology
- * Autoimmunity
Background:
- * Warm-reactive red blood cell (RBC) autoantibodies can lead to hemolysis.
- * The role of multiple immunoglobulins coating RBCs beyond IgG is not fully understood.
Purpose of the Study:
- * To investigate the effects and interrelationships of multiple immunoglobulin coating on RBCs.
- * To determine the association of multiple immunoglobulins with hemolysis and other factors.
Main Methods:
- * Enzyme-linked direct antiglobulin tests and agglutination methods were used to detect immunoglobulin coating in 404 patients.
- * Chi-square tests were employed to analyze population differences.
- * Quantification of RBC-bound IgG, IgG subclasses, C3d, and serum haptoglobin levels were assessed.
Main Results:
- * Multiple immunoglobulins were detected in 37% of samples by enzyme-linked tests, versus 15% by agglutination.
- * Multiple immunoglobulins correlated with higher quantities of IgG, multiple IgG subclasses, IgG3, C3d, and lower haptoglobin levels.
- * Low haptoglobin levels showed a significant association with multiple immunoglobulins, independent of IgG quantity and subclass.
Conclusions:
- * Multiple immunoglobulin coating is a significant, often undetected, cause of hemolysis.
- * It signifies a generalized autoimmune response involving IgG quantity, subclass, and complement.
- * Multiple immunoglobulins possess independent hemolytic activity.