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Biomedical subjects

V Kiefel

Publications and source records attributed to V Kiefel.

132 records · Page 8Linked to original sources
PubMedDate not supplied

The clinical significance of HLA antigens on red cells. Survival studies in HLA-sensitized individuals.

To investigate the clinical significance of HLA determinants expressed on red cells (RBCs), 51Cr survival studies were carried out in six women (four healthy individuals, two patients with solid carcinoma) immunized against HLA antigens by pregnancy or blood transfusions, respectively. Donors were selected who were compatible in typical RBC antigen systems assayed by conventional techniques but were mismatched for the HLA antigens in question. Crossmatches also were performed with RBC, as well as with lymphocytes, by means of a radioimmune anti-IgG test (RIAT). We found that RBC survival was shortened in all cases. The mean life-span of RBCs depended on antigen specificity rather than on the antibody strength. HLA incompatibility of RBCs could be monitored by the RIAT in all donor/recipient pairs. We conclude that a shortened mean life-span of RBC is to be expected by HLA antibodies, especially when HLA-B7 is involved, but the severity of an in vivo immune reaction in HLA incompatible transfusions cannot be predicted from the in vitro tests used.

Adult↗
PubMedDate not supplied

Nomifensine-induced immune hemolytic anemia and posttransfusion purpura in the same patient.

A 53-year-old white woman had severe hemolytic anemia while taking nomifensine. A drop of hemoglobin to 61 g per I prompted the transfusion of two units of packed red cells. Nine days later, severe thrombocytopenia with multiple petechiae ensued. Both hemolysis and thrombocytopenia resolved promptly upon withdrawal of the drug and short-term prednisolone treatment. Serologic studies showed nomifensine-dependent, metabolite-specific red cell antibodies as the cause of immune-mediated hemolysis and, in serum samples obtained after purpura, strong platelet-specific PlA1 and weak HLA antibodies suggested a diagnosis of posttransfusion purpura.

Anemia, Hemolytic↗
PubMedDate not supplied

Metabolite-specific (IgG) and drug-specific antibodies (IgG, IgM) in two cases of trimethoprim-sulfamethoxazole-induced immune thrombocytopenia.

Two cases of trimethoprim-sulfamethoxazole (TMP-SMX)-induced immune thrombocytopenia are reported in which unusual drug-dependent platelet antibodies were demonstrated by immunofluorescence and enzyme-linked immunosorbent assay. Whereas two distinct sulfamethoxazole-dependent antibodies of the IgG and IgM class were detectable in the serum of one patient, the serum of the other patient contained a platelet antibody exclusively reactive with N-4-acetyl-sulfamethoxazole, a metabolite of sulfamethoxazole. Urine from a healthy volunteer collected after administration of therapeutic doses of TMP-SMX proved to be an appropriate source of ex vivo metabolites for antibody testing. The results of this study stress the role of metabolite-specific antibodies in drug-dependent immune thrombocytopenia and underscore the necessity of including metabolite preparations of drugs in serologic analyses.

Aged↗
PubMedDate not supplied

Platelet transfusion refractoriness associated with two rare platelet-specific alloantibodies (anti-Baka and anti-PlA2) and multiple HLA antibodies.

A 65-year-old patient with pancytopenia resulting from osteomyelosclerosis became refractory to platelet transfusions during long-time transfusion support. He developed two rare, platelet-specific antibodies (anti-PlA2 and -Baka) disguised by strong, multispecific HLA antibodies. The specificity of the platelet-specific antibodies was detected by a newly designed enzyme-linked immunosorbent assay using glycoprotein-specific monoclonal antibodies for immobilization of platelet antigens.

Aged↗