Erythrocyte autoantibody with unusual specificity.
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Biomedical subjects
Publications and source records attributed to G W Bird.
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In vivo erythrocyte polyagglutination of microbial origin is usually a transient condition. In two children with bowel disorders, erythrocyte T-polyagglutination persisted for 12 months in one case and for seven months in the other. Both cultures required both transfusions to support surgery. Washed red cell concentrates were transfused instead of whole blood to prevent dangerous destruction of T-transformed erythrocytes by anti-T antibodies normally present in the plasma of blood donors.
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This report describes a case of persistent polyagglutinability restriced to the red blood cells, and associated with hemolytic anemia in a 20-year-old male. AIME WITH NORMAL INTERVALS. His red blood cells were weakly agglutinated by almost all adult sera. No autoagglutination was noted and the direct antihuman globulin test was negative. Polyagglutinability of his red blood cells was clearly distinguishable from T, Tn and Tk. No reaction was noted with Dolichos biflorus and peanut extracts. The cells differed from normal erythrocytes in their positive reactions with various snail agglutinins and their weak reaction with a range of anti-H reagents. There was normal aggregation by Polybrene. MN determinants were normally expressed. The symbol "VA" is roposed for this type of polyagglutination.
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Tn polyagglutination (persistent mixed-field polyagglutination) occurring in a patient with an acute myelocytic leukemia is described. The association of this RBC membrane change, thought to be due to somatic mutation at stem cell level, with a myeloproliferative disorder, has not been previously reported.
A case of acute erythroleukaemia is described. The patient's RBC, which at first appeared to be a mixture of groups B and O, were shown in fact to be a mixture of normal B and very weak B.
Cad, Sd(a++) or Super Sda is a rare, inherited, dominant blood group character which is of much interest, not only with regard to problems in pretransfusion tests (erythrocyte polyagglutination) but also in the field of lectin specificity. We have studied this blood group character in a British family with Eastern connections and present a brief account of its serological and clinical importance. Most persons are Sd(a+) but there is a wide distribution of antigen strength, ranging from ordinary Sd(a+) to Cad. Most persons also have weak anti-Sda in their serum; this is ordinarily of no clinical importance, but could cause problems if Cad bloods are transfused. The chief structural determinant of Cad specificity is N-acetyl-D-galactosamine in alpha-linked position, yet it is clearly distinguishable by use of appropriate lectins from other blood group antigens, A and Tn, which also have this acetyl-hexosamine as their chief structural determinant. A method for the rapid identification of Cad, applicable to all ABO groups, is described. The lectin of Dolichos biflorus, which is specific for N-acetyl-D-galactosamine in alpha-linked position, reacts strongly with A(A1), Tn and Cad cells, its action on Cad cells being much the strongest. Absorption-elution studies show that one and the same lectin reacts with both A1 and Tn cells. Absorption with Cad cells abolishes activity for A1, Tn and Cad cells; whereas absorption with A1 or Tn cells leaves activity for Cad. This does not necessarily indicate that anti-Cad is a separate component since the same result can be obtained by simply diluting the Dolichos reagent. However, eluates from Cad cells react only with Cad cells, whereas eluates from A1 or Tn cells react with A1, Tn and Cad cells.
Three examples of non-syphilitic paroxysmal cold haemoglobinuria (PCH) in children are described which occurred, within a period of 16 days, in association with a febrile illness. No definite viral aetiology or obvious epidemiological association could be established. A Donath-Landsteiner antibody of anti-P specificity was demonstrated in all three patients. The serological aspects of PCH are critically discussed.
A computer scheme for a large antenatal serology service is described. A primary request form (for mother, father or child) has been developed. Standard reports are produced by the computer and are issued with a tear-off slip which should accompany subsequent specimens. Complicated reports are made by special letter. An instruction booklet is issued to all users. Information on patients and clinically significant antibodies is held in a special computer file and is regularly updated. The system provides an efficient and reliable day-to-day service and readily accessible data for retrospective research. A brief note on the computer elements of the system is provided.
The appropriate ABH-gene specified glycosyltransferases in the plasma of the Birmingham chimaera were estimated. These observatiions and the demonstration of A1Leb blood group specific glycosphingolipid in the plasma indicate that the minority population of red blood cells probably represents the true blood groups of the patient.
Erythrocytes of a patient with hereditary erythroblastic multinuclearity with a positive acidified serum test (HEMPAS) were tested with many seed extracts and various other reagents. Serological evidence of membrane abnormality was confirmed. Various anti-H reagents reacted relatively poorly with HEMPAS cells. HEMPAS cells have both enhanced i and depressed H antigens. A brief note on a 'new' anti-H lectin (Cytisus glabrescens) is provided.
Six further examples of haemagglutinins from Salvia are reported; one is anti-T and 5 are anti-Tn.