Rare Autoantibody Mimics Anti-C and Anti-e Specificity in Patient with Aplastic Anemia

Alloantibodies for the Rh blood group are the most immunogenic antibodies found in the Chinese population, typically causing acute or delayed hemolytic transfusion reactions and fetal and neonatal hemolytic diseases. Autoantibodies are generally considered nonspecific, and approximately 50% of warm antibodies are secondary to a variety of diseases, especially hematologic tumors. In this case report, a rare autoantibody that mimics anti-C and anti-e specificity was identified.

A 17-year-old adolescent with aplastic anemia was awaiting transfusion due to anemia. Routine laboratory testing before transfusion revealed that antibody screening was positive. Antibody identification and blood group antigen typing were performed to identify antibody specificity.

Antibodies in the patient's plasma and red blood cell release solution were identified as anti-C and anti-e specific. The patient's proximal red blood cells were separated by capillary centrifugation to identify the Rh blood group as DCeEe. Antibodies in the patient's plasma were suspected of being autoantibodies, a rare type of antibody. Screened C and e antigen-negative blood for transfusion was effective, and the patient's anemia was re-lieved. The patient was discharged after transfusion.

Finding suitable blood for transfusion in patients with hemolytic anemia caused by warm autoantibodies is a challenge. Managed mimic antibodies are the same as alloantibodies, and matching-related antigen-negative blood is the first choice for transfusion in patients with mimic warm autoantibodies. However, C and e antigen-negative blood is rare among the Chinese population.