患有由IgM自身抗体引起的ABO血型鉴定困难的患者的鉴定策略
Chen Wang1, Xian Huang2, Lina Wu2
1Department of Blood Transfusion, Key Laboratory of Cancer Prevention and Therapy in Tianjin, Tianjin's Clinical Research Center for Cancer, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China.
这项研究确定了罕见的ABO血型自身抗体. 一种自身抗体与疾病有关,另一种来自免疫检查点抑制剂,强调需要谨慎的输血策略.
科学领域:
- 血液学 血液学 血液学
- 免疫学 免疫学 免疫学
- 输血医学 输血医学
背景情况:
- 对 ABO 血型抗原的自身抗体很少见,但在临床上具有意义.
- 了解它们的起源对于有效的患者管理至关重要.
- 由于自身抗体的存在,在 ABO 反向组类型化中存在挑战.
研究的目的:
- 调查罕见的ABO自身抗体的特征和产生原因.
- 分析这些自身抗体患者的临床输血策略.
- 识别和分析两例罕见的ABO血型抗原特异性自身抗体.
主要方法:
- 血清学方法:常规管道方法,凝微柱测定,吸收-脱离技术.
- 抗体表征:直接抗球蛋白试验,硫烯试剂处理.
- 分子分析:用于 ABO 基因型的桑格测序;对患者的病史和输血病史的审查.
主要成果:
- 案例1:A1型个体具有自身抗A抗体,与潜在疾病相关的产生.
- 案例2:A1B型个体具有自身抗B抗体,与免疫检查点抑制剂使用相关的产生.
- 这两种病例均通过血清学和分子检测得到证实.
结论:
- 在排除其他抗体类型后,在怀疑的A或B抗原抗体中考虑ABO自身抗体.
- 输血策略需要根据交叉匹配,热幅度和血液溶解测试仔细选择血液制品.
- 在输血期间对患有ABO自身抗体的患者进行密切监测是必不可少的.
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