Multiple or uncommon red cell alloantibodies in women: association with autoimmune disease

Patients with multiple or uncommon red cell (RBC) alloantibodies require special efforts in the blood bank. This study investigated whether such persons had other immune-related conditions that might help to explain or predict their propensity for RBC antibody formation.

Charts were retrospectively reviewed of 29 men and 83 women with multiple (> or = 3) RBC antibodies of potential clinical significance, uncommon RBC antibodies (anti-e, -Kpb, -Jkb, -Fyb, -S, -U, -Yta, -Dib, -Ata), or both. The clinical features in 43 women with multiple antibodies were compared to those in two equal-sized control cohorts of women matched for transfusion-related diagnoses, but having either one RBC antibody or none.

Women with uncommon RBC antibodies had a 33-percent (18/54) prevalence of autoimmune disease. Twenty-eight percent of the 43 women with multiple antibodies had autoimmune disease, compared to 14 percent of women in the cohort with one RBC antibody (p = 0.09) and 7 percent of those in the cohort without RBC antibodies (p = 0.01). Only one of the 29 men had autoimmune disease.

Autoimmune disease is a common underlying factor in women who make multiple or uncommon RBC alloantibodies of potential clinical significance.