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PubMed2001

[Immunorelated pancytopenia].

OBJECTIVE: A report of a group of patients with pancytopenia which might be related to abnormal immunity. METHODS: The clinical and laboratory features of 29 patients with positive bone marrow mononuclear cell (BMMNC) Coombs tests were analyzed. RESULTS: Most of these cases were pancytopenia with normal or decreased bone marrow cellularities and increased normoblasts. They were all found to have negative results of conventional hemolysis tests and hematopoietic nutrient determination and had no evidence of malignant clonal hematopoiesis. However, all of them showed positive BMMNC-Coombs test and good response to corticosteroids. CONCLUSION: Immunorelated pancytopenia might be caused by abnormal immunity (especially autoantibody) mediated destruction or abnormal function of blood cells. It is beneficial to differentiate immunorelated pancytopenia from aplastic anemia or myelodysplastic syndromes.

Adolescent↗
PubMed1964

HEMOLYTIC TRANSFUSION REACTIONS.

After receiving apparently compatible blood three patients suffered hemolytic reactions. The compatibility tests were by saline and indirect Coombs technique including a screening tube of group 0 cells. The antibodies responsible for these reactions were not clearly demonstrable for several days following the transfusion. In two instances the antibody was anti-E.These case reports point up the following. (a) Currently used cross-matching procedures will occasionally fail to demonstrate an incompatibility. (b) In two of the cases the direct Coombs test was negative on an immediate post-transfusion specimen, when it could have been of great aid in diagnosis. (c) When a transfusion reaction of hemolytic type is suspected, a follow-up study several days after the reaction may clarify the diagnosis; when possible, transfusions should be avoided in the interim.

Antibodies↗
PubMed1986

[Immunoenzyme method in the diagnosis of human brucellosis].

The optimum conditions for the determination of specific antibodies in the sera of brucellosis patients by means of enzyme immunoassay (EIA) have been selected. The comparative study of the specificity and sensitivity of EIA and other serological tests has demonstrated that EIA has high diagnostic effectiveness in the diagnosis of acute and chronic brucellosis. The presence of direct correlation between the results of EIA and Coombs' test is observed, which is indicative of the capacity of EIA for detecting both complete and incomplete specific antibodies. It should be pointed out that in all cases the titer of specific antibodies in EIA has been found to be 5-16 times higher than in Coombs' test, the passive hemagglutination test, and agglutination test.

Antibodies, Bacterial↗
PubMedDate not supplied

[Seroprevalence of brucellosis in agricultural workers in the coastal zones of Castellón, Spain].

OBJECTIVE: To estimate the seroprevalence of brucellosis in agricultural workers. MATERIAL AND METHODS: This cross-sectional study was conducted between 1996 and 1997 at Unidad de Salud Laboral del Centro de Salud Pública (CSP) in Castellón, España (Public Health Center Occupational Health Unit), among 482 subjects applying for certification to handle pesticides for agricultural use. Serologic testing consisted of rose Bengal staining, Wright's agglutination, and antibrucella Coombs tests: Statistical analysis consisted in estimation of prevalence figures and logistic regression modelling. RESULTS: Fifteen subjects (3.1%, 95% CI 1.8%-5.1%) had titers of 1/40 or higher to Wright and/or Coombs tests; all were negative to rose Bengal staining. No high occupational risk was observed. CONCLUSIONS: A low prevalence of brucellosis was found. The English version of this paper is available at: http://www.insp.mx/salud/index.html.

Adolescent↗
PubMed1982

Autoimmune hemolytic anemia in childhood Hodgkin's disease.

Autoimmune hemolytic anemia (AIHA) is very rarely associated with neoplasia in childhood. However, we have observed AIHA in three children with Hodgkin's disease (HD) in the past 7 years. AIHA presented either prior to, simultaneously with, or years after the diagnosis of HD. Antibodies against erythrocytes were nonspecific. The relationship of AIHA to the activity of underlying HD was quite varied among these three patients. Surgery, radiation therapy, and chemotherapy all may alter the course of AIHA. Coombs' tests may continue to be persistently positive when anemia is absent. Currently, all three patients have no evidence of recurrence of HD, no anemia, negative Coombs' tests 5 years, 22 months, and 14 years 10 months after the initial diagnosis of HD. AIHA should be considered in a child with HD who develops anemia and HD should also be considered in the differential diagnosis in a child with chronic AIHA.

Adolescent↗
PubMed1985

Absence from sera from normal individuals or from rifampin-treated leprosy patients (THELEP trials) of antibody to rifamycin-protein or rifamycin-membrane conjugates.

It has been reported that normal individuals have precipitating antibody which binds to rifamycin-conjugated proteins. An enzyme-linked immunosorbent assay has failed to confirm this claim, although antibodies demonstrable in a solid-phase binding assay are easily raised in mice if complete adjuvant is used. Moreover, no antibodies to rifamycin-protein conjugates were found in sera from the patients included in THELEP trials of six rifampin-containing regimens. Similarly, there was no antibody by the indirect Coombs test performed in another laboratory. Further studies using rifamycin-membrane conjugates regarded as more likely to be immunogenic in vivo also failed to reveal antibody in patients' sera, although this technique revealed an interesting antibody in one of four control sera known to be positive by the indirect Coombs test.

Animals↗
PubMed1991

Coombs-positive autoimmune hemolytic anemia in ulcerative colitis--a report of two cases.

Two cases of ulcerative colitis with a positive Coombs test are reported herein. In a 30 year old woman, hemolytic anemia was well controlled by excision of a rectal stump left over from a former operation. A 53 year old woman had a positive Coombs test without clinical hemolytic anemia 10 years after undergoing a total procto-colectomy with ileo-anal anastomosis. Thus we concluded that total procto-colectomy may be preventive, as well as therapeutic, for Coombs positive hemolytic anemia associated with ulcerative colitis.

Adult↗
PubMed1985

Familial canine dermatomyositis: clinicopathologic, immunologic, and serologic studies.

Laboratory studies were performed on 3 Collies with familial canine dermatomyositis, 6 progeny from a breeding of 2 of the Collies (incross litter), and 4 progeny from the breeding of an affected Collie male and a normal Labrador Retriever (outcross litter). Hematologic abnormalities were leukogram changes consistent with inflammation, and, in 2 severely affected incross dogs, anemia of inflammatory disease. Serum muscle enzyme activities were not markedly increased. High concentrations of immune complexes and proportionally increased total immunoglobulin G were present in the sera of moderately and severely affected incross dogs. The same dogs had weakly positive direct Coombs' tests, and 1 affected outcross dog had a strongly positive direct Coombs' test. Rheumatoid factor was present in a severely affected incross dog. A few dogs had polyclonal globulin increases that were attributed to inflammation. Low antibody titers to canine calicivirus were present in 3 dogs and a low titer to canine coronavirus was present in 1 dog.

Animals↗
PubMed1979

Serological diagnosis of tuberculosis. Evaluation of two years' experience.

Two years' experience of a simple serological test for the diagnosis of tuberculosis has been evaluated. This test fails to distinguish clearly between tuberculous and non-tuberculous patients. There is an unacceptably high incidence of false positive and false negative results, although the latter would be reduced by taking the highest titre values of several samples from one patient. Modification of the test to eliminate IgM agglutination produced a marked fall in false positive results. These preliminary results suggest that this modified test is more useful, in that a positive test is a strong indication of tuberculosis. The use of a Coombs' test to agglutinate incomplete complexes did not improve results.

Adsorption↗
PubMedDate not supplied

Ulcerative colitis, autoimmune hemolytic anemia and rectovaginal fistula: report of a case.

A case of autoimmune hemolytic anemia associated with ulcerative colitis and rectovaginal fistula in a 27-year-old woman is reported. It appeared during the first episode of ulcerative colitis occurring in the immediate puerperium. Laboratory studies revealed a positive direct Coombs test with polyspecific sera and monospecific for IgG. Panagglutinins and cold agglutinins with titers under 1:50 were also demonstrated. Treatment with steroid therapy was sufficient for a swift and complete recovery of the patient, the direct Coombs test becoming negative six weeks after admission.

Adult↗
PubMed1994

Association of antimitochondrial antibodies type 5 and anti-beta 2 glycoprotein I antibodies in the antiphospholipid syndrome.

OBJECTIVE: To evaluate if antimitochondrial type 5 antibodies (AMA5) might be included among antiphospholipid syndrome (APS) markers. METHODS: In a retrospective study, blood variables of 48 patients with AMA5 were analyzed in relationship with clinical and biological markers of APS and systemic lupus erythematosus (SLE). RESULTS: We observed a high prevalence of false biological test for syphilis (95%), lupus anticoagulant (LAC) (71%), anticardiolipin antibodies (aCL) of IgG (71%) and IgM (75%) isotype, positive direct Coombs' test (54%), thrombocytopenia (52%), anti-B2 glycoprotein I antibodies (38%). Twenty-nine patients (61%) had at least one clinical manifestation of APS; 42% had recurrent arterial and/or venous deep thrombosis and 21% had recurrent fetal loss. But, for 2 patients, AMA5 were the sole detected immunological marker. Moreover, SLE was observed in 35% of the patients. These were different from 100 control patients with SLE with the respect to skin involvement and dsDNA antibodies which were less frequent (p < 0.01) and aCL, LAC, false biological test for syphilis (p < 0.001), positive direct Coombs' test and thrombocytopenia (p < 0.05) which were more frequent. CONCLUSION: Our data suggests (1) AMA5 is another marker of the APS (2) in patients with SLE, AMA5 seems to be a marker of a subset of SLE. This appears to justify the routine detection of these antibodies.

Adolescent↗
PubMed1989

Evaluation of a delayed-type hypersensitivity test for the diagnosis of Brucella abortus infection in cattle.

The delayed-type hypersensitivity (DTH) test was used to diagnose brucellosis in two cows experimentally induced with brucellosis, and 176 dairy cows from a farm suspected of brucellosis. DTH test results were compared with results of the milk ring test, the serum agglutination test, the complement fixation test and the Coombs test. Cows positive in the DTH test and in one of the other tests were examined bacteriologically. In experimentally infected animals the DTH test was positive 10 days after infection, 1-4 weeks before serologic tests indicated brucellosis. Although the DTH test was positive during the whole experiment, on the one occasion when serologic titres were high, it was negative. Of the 176 dairy cows, 45 were positive in one or more serologic tests. In twelve cows (29%) the diagnosis was inconclusive because they were positive in only one of the serologic tests. In these cases the DTH test confirmed the infection. Three cows with high serologic response tested negative in the DTH test. B. abortus was isolated from 13 of 15 cows examined. We conclude that when serologic results are ambiguous, the DTH test is a useful additional technique for diagnosing brucellosis.

Animals↗
PubMed2005

Flow cytometric evaluation of bound IgG on erythrocytes of anaemic dogs.

The detection of red blood cell (RBC)-bound immunoglobulins in case of anaemia with the direct agglutination test (DAT or Coombs test) has been reported to be of low sensitivity. We therefore tested the applicability of flow cytometry for the detection of canine IgG on RBC using two different IgG-specific secondary reagents: goat-anti-dog IgG (GalphaD-IgG) and rabbit-anti-dog IgG (RalphaD-IgG). Membrane staining RBC samples were performed at 4 degrees C. Comparisons of agglutination test at 37 degrees C and 4 degrees C showed, that binding of the secondary antibodies at 4 degrees C was more sensitive compared to agglutination at 37 degrees C and the two antisera differed considerable in their agglutination activity. Binding of GalphaD-IgG and RalphaD-IgG to RBC of healthy dogs (n=15) was low and mean fluorescence intensities were taken to calculate thresholds above which RBC of patients were judged positive. As in agglutination tests, both secondary antisera displayed considerable differences (concentration-dependent binding and histogram profiles) after flow cytometric analysis. Using flow cytometry, with GalphaD-IgG 8 of 17 agglutination-negative patients were positive and RalphaD-IgG was positive with 3 of 3 agglutination-negative RBC samples. Thus, flow cytometric analysis of proved to be a sensitive technique, detecting RBC-bound canine IgG of DAT-negative patients. The results of both techniques, however, are significantly influenced by the used IgG-specific polyclonal reagents.

Agglutination Tests↗
PubMed2006

Virchow's node, jaundice, and weight loss--lymphoma mimicking gastrointestinal malignancy.

BACKGROUND: A 46-year-old white male with a history of well-controlled paranoid schizophrenia presented with painless jaundice, progressive anorexia, weight loss, and dyspnea of 3 months' duration. His only medication at presentation was the antipsychotic olanzapine, taken orally. INVESTIGATIONS: Physical examination and laboratory tests, including a complete blood cell count, electrolyte, lactate dehydrogenase and haptoglobin levels, liver function tests, and a Coombs' test; CT scan of the chest and abdomen; invasive investigations, including thoracentesis and pleural fluid analysis, bone-marrow biopsy, and left supraclavicular lymph-node biopsy. DIAGNOSIS: Diffuse large B-cell lymphoma. MANAGEMENT: Large-volume thoracentesis. Rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone chemotherapy followed by dexamethasone, cytarabine, and cisplatin chemotherapy, and autologous stem-cell transplantation.

Anorexia↗
PubMed1997

A retrospective clinical study of canine leishmaniasis in 150 dogs naturally infected by Leishmania infantum.

The clinical and laboratory findings observed in 150 dogs naturally infected by Leishmania infantum, from a large endemic area of southern Italy, are described. There was a gradual onset of clinical signs and the course of the disease was progressive in almost all the cases. The majority of the dogs were mongrels (43.3 per cent), male (64.7 per cent), of medium size (50.6 per cent), three to seven years old (64.7 per cent), and living outdoors (60 per cent). They showed generalised (56.7 per cent) or symmetrical (32 per cent) lymphadenomegaly; the mucous membranes of 87 of the dogs (58 per cent) were pale and moderate or severe splenomegaly was diagnosed in 80 dogs (53.3 per cent); weight loss was observed in 32 per cent of the animals. Skin abnormalities were very common, and included dry exfoliative dermatitis (56 per cent), ulcers (40 per cent) periorbital alopecia ('lunettes') (18 per cent), diffuse alopecia (14 per cent) and onychogryphosis (24 per cent). Ocular signs were observed in 24 dogs (16 per cent) including 16 cases of keratoconjunctivitis (three with keratoconjunctivitis sicca), six cases of moderate uveitis and two cases of panophthalmitis. The acute form of the disease was diagnosed in only six dogs and was characterised by fever and generalised lymphadenomegaly, and by the absence of skin lesions. Another six dogs had severe renal failure without systemic clinical signs of leishmaniasis. The most important laboratory findings were a severe or moderate increase in gammaglobulins, hypoalbuminaemia, hyperproteinemia and anaemia. Cultures or cytology tests for L infantum parasites were positive in 134 of the dogs. Following the standard procedures developed for human lymph node and bone marrow cytology tests, the leishmania density in the dogs varied from 1+ to 2+. Leishmania antibody titres were high (> 1:160) in almost all the dogs. Immunological tests for autoantibodies were positive in 25 of 53 dogs tested in the antinuclear antibody (ANA) test, in 15 of 43 dogs tested in the latex test and in five of 24 dogs tested in the Coombs test.

Animals↗
PubMed1980

Graft-versus-host reaction after allogeneic hemopoietic tissue transplantation in rabbits conditioned with cyclophosphamide.

Graft-versus-Host Reaction (GvHR) was investigated in rabbits conditioned with a cyclophosphamide, which was given as a single injection of 110 mg/kg of body weight or as 4 injections of 50 mg/kg given on each of four successive days, before allogeneic bone marrow or spleen cells transplantation. The GvHR was of a chronic type. Splenomegaly was significant in the animals receiving spleen cell grafts, but not in the recipients of bone marrow transplants. In each of experimental groups delayed body weight gain and autoallergic phenomena were observed. Autoantibodies against erythrocytes, tested by direct Coombs test, were found in almost all graft recipients. This was a long lasting phenomenon since sensitized erythrocytes were found even after six months after transplantation. Cytotoxic autoantibodies against lymphocytes were present in the sera of about 20% of the recipients, and not longer than 30 days after transplantation. They proved not to be anti-RLA antibodies.

Animals↗
PubMed1997

Primary biliary cirrhosis associated with mixed type autoimmune hemolytic anemia and sicca syndrome: a case report and review of literature.

A case presenting with an unusual association of primary biliary cirrhosis and mixed type autoimmune hemolytic anemia plus sicca syndrome is described. The 49-yr-old female primary biliary cirrhosis patient had a confirmed sicca syndrome and presented with jaundice and life-threatening anemia. Laboratory tests revealed positive Coombs' test with coexisting cold and warm autoantibodies. She was successfully treated by blood transfusion with packed red cells lacking any red cell antigens corresponding to serum alloantibodies and pulse methylprednisolone therapy. The patient remained stable under maintenance treatment using oral steroids and ursodeoxycholic acid. This case is probably the first reported showing an association between primary biliary cirrhosis and mixed type autoimmune hemolytic anemia plus sicca syndrome and was probably induced by heterogenous and complicated autoimmune reactions.

Administration, Oral↗
PubMed1997

Autoimmune haemolytic anaemia, immune thrombocytopenia, and leucopenia. An unusual presentation of Hodgkin's disease.

We report an unusual case of nodular sclerosing Hodgkin's Disease in a 17-year-old woman presenting with intermittent fever, progressive weight loss and enlarged cervical and axillary lymph nodes. Laboratory tests revealed severe Coombs' positive haemolytic anaemia, and progressive thrombocytopenia and leucopenia, associated with erythroid, myeloid and megakaryocytic hyperplasia, but with no evidence of lymphomatous infiltration in the bone marrow. Transfusion of compatible blood became possible only after prednisone therapy and a single intravenous dose of vincristine. Appropriate chemotherapy led to normalization of the peripheral blood counts and a negative direct Coombs' test.

Adolescent↗