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PubMed1980

Rate of Rh immunization after induced abortion.

The occurrence of Rh immunization was investigated in 386 secundigravidae whose first pregnancy was terminated by induced abortion and who were not given anti-D immunoglobulin after the induced abortion. Of these, 6 (1.57%) already proved to be seropositive at the beginning of their second pregnancy, another 6 (1.57%) became positive by the end of the second pregnancy, i.e. 3.14% altogether as demonstrated with papain-treated RBC. If instead the indirect antiglobulin (Coombs) test was used, 3 women (0.77%) proved to be positive at the beginning and 9 (2.31%) at the end of the second pregnancy. Supposing that 0.5% of the secundigravidae became immunized during the second pregnancy, the rate of immunization after induced abortion in non-protected cases may be calculated to be 2.64% using the papain technique and 1.81% when the antiglobulin test is applied.

Abortion, Induced↗
PubMed1986

Use of an enzyme indirect antiglobulin test for the diagnosis of autoimmune haemolytic anaemia in the dog.

Blood samples from 34 dogs with autoimmune haemolytic anaemia (AIHA) were studied using a variety of serodiagnostic tests. Enzyme enhancement of red cells was found to be necessary for an unequivocal laboratory diagnosis of AIHA because other techniques, the direct and the indirect Coombs' tests, often gave negative results. The most frequently encountered auto-antibody was an IgG, with a titre of 1024 or more.

Anemia, Hemolytic, Autoimmune↗
PubMed2003

[Acute prostatitis as the 1st symptom of brucellosis].

OBJECTIVES: To report a case of acute prostatitis as the first symptom of brucellosis. METHODS: 43-year-old patient who presented with a clinical picture of acute prostatitis and a febrile syndrome for seven days. Physical exam, blood and urine analysis and microbiological tests, and specific serologic studies were performed. RESULTS: Microbiological diagnosis was negative for bacteria, but Bengala pink (+), antibrucella serum agglutination (+) 1/320, and anti-Brucella Coombs test (+) 1/5120. Specific treatment was started with doxycyclin 100 mg b.i.d for 45 days and streptomycin 1 gr o.d for 15 days, with a positive outcome. CONCLUSIONS: The genitourinary tract is the second most frequent localization, being the testicle the most frequently affected organ, although it can also be localized in other areas of the urinary tract.

Acute Disease↗
PubMed1996

Seroprevalence of brucella antibodies among persons in high-risk occupation in Lebanon.

Prevalence of brucella-specific antibodies was measured in 597 persons in high-risk occupations living in 10 regions of Lebanon using the standard agglutination test (SAT), anti-human globulin (Coombs') test (AHGT) and enzyme-linked immunosorbent assay (ELISA) for measuring immunoglobulin G (IgG), IgM and IgA. The study population consisted of butchers (54%), farmers (35%), laboratory technicians (8%), abbatoir workers (2%) and veterinarians (1%), with 82% males and 18% females. The overall seroprevalence based on SAT and AHGT titres of > or = 80 was 1.7% and 15%, respectively, but seroprevalence varied by region from 0-5% in SAT and from 3.4-34% for AHGT. The overall seroprevalence based on ELISA IgG (OD > or = 0.6), IgM (OD > or = 0.6) and IgA (OD > or = 0.3) was 57, 61 and 26%, respectively. The highest seroprevalence was noted in Biqaa (34%), Kisrwan (24%), Shouf (21%), Sidon (16%) and Aley (12%) regions. Nineteen percent of those surveyed reported symptoms that could be associated with brucellosis. We conclude that exposure to brucellosis is high among persons in high-risk occupations from all surveyed regions in Lebanon. Such findings should be used to design control measures especially now that the 17 years of civil strife is over.

Antibodies, Bacterial↗
PubMed1975

Antazoline-induced immune hemolytic anemia, hemoglobinuria, and acute renal failure.

A case of repeated antazoline-induced immune hemolytic anemia, thrombocytopenia, hemoglobinuria, and acute renal failure is reported. The first episode of renal failure occurred after an i.v. pyelography causing an anaphylactic shock, and the two later episodes were preceded by allergic reaction to drugs. Antazoline was given among other remedies, but this drug was the only one used for treatment on every occasion. The clinical picture and the immunological tests, including an antazoline-dependent Coombs' test, indicate that the blood disorders might have been caused by a type 2 allergic reaction and renal lesion by a type 3 reaction, at least on the second and third occasions.

Acute Kidney Injury↗
PubMed2001

Prevention of bilirubin encephalopathy.

Prevention of bilirubin encephalopathy is based on the detection of infants at risk of developing a significant hyperbilirubinemia. This task can be accomplished by performing a simple umbilical cord blood test, such as blood group, Rh, Coombs' test and glucose-6-phosphate dehydrogenase, in order to detect hemolytic diseases. In preterm infants, the prevention of hyperbilirubinemia with phototherapy is a relatively simple task, since these infants are cared for in hospital. Early hospital discharge of full-term neonates represents a major concern. The management of neonatal jaundice requires that therapy begins when total serum bilirubin levels are significantly below the levels at which kernicterus is considered an immediate threat. Unfortunately, determination of serum bilirubin is a painful procedure, and is not very accurate since there is a high variability in laboratory measurements. The accuracy and precision of a new transcutaneous bilirubin measurement, comparable to the standard of care laboratory test, makes the daily evaluation of transcutaneous bilirubin measurement a useful tool in distinguishing physiological from nonphysiological hyperbilirubinemia, and determining the bilirubin increment in the first days of life. Full-term neonates who lose a significant amount of weight are especially at risk of significant hyperbilirubinemia and must be treated with ad libitum feeding and intensive phototherapy.

Bilirubin↗
PubMed1990

Fatal primary Epstein-Barr virus infection masquerading as histiocytic medullary reticulosis in young children in Taiwan.

We reported 3 fatal cases of primary Epstein-Barr virus (EBV) infection resembling histiocytic medullary reticulosis (HMR) in young children in Taiwan, where an HMR-like illness has been previously found to be prevalent. The disease ran a fulminant course, manifesting as fever, anemia, jaundice, skin rash, pulmonary infiltration, and/or hepatosplenomegaly lasting for only 1-3 weeks. Laboratory tests revealed no hemolytic anemia and Coombs test was negative. Sepsis or HMR was the main clinical differential. At autopsy, the spleen, liver, lymph node, lung, and bone marrow showed infiltration of atypical "histiocytes" or blasts, lymphocytes, and mature histiocytes with hemophagocytosis. Immunophenotype and gene rearrangement studies of the lymphoid tissues revealed that these atypical "histiocytes" were actually polyclonal B immunoblasts in one case and transformed T lymphocytes in the remaining 2 cases, representing two different types of virus-host interaction. Southern blot and in situ hybridization studies on frozen lymphoid tissues demonstrated the presence of EBV DNA in all 3 patients; the study for cytomegalovirus was negative. The young age of these patients, closely correlated with the prevalent age of primary EBV infection in the general populations in Taiwan, strongly suggest that these childhood cases of previously diagnosed HMR-like disease may actually represent a lethal form of primary EBV infection or fatal infectious mononucleosis.

DNA, Viral↗
PubMed1977

[Study of the immunological effectiveness of the enteral vaccination of volunteers with detergent Sonne dysentery monovaccine].

The authors evaluated the immunological results of enteral and subcutaneous injection of detergent Sonne dysentery vaccine to volunteers (changes in homo- and heterologous antibodies in the blood and saliva recorded by means of common indirect hemagglutination test and that modified according to Coombs' test, and IgG, IgM, and IgA concentration recording. Both immunization methods induced specific antibody formation: enteral vaccination caused chiefly the accumulation of secretory antibodies of IgA class, and subcutaneous -- of serum antibodies belonging to IgG class. The supposed mechanisms determining the capacity of enteral administration of the antigen to provoke an immune response different from that caused by its subcutaneous injection are discussed.

Administration, Oral↗
PubMed1987

Therapeutic possibilities of thymopoietin fragments (TP3 and TP4) based on experimental animal models.

The effects of thymic hormones are focused on the induction of T-cell subpopulations and restoration of the reactivity of an impaired immune system. TP3 and TP4 (corresponding to thymopoietin 32-34 and 32-35) exert a thymic hormone substitution effect. These peptides elicit dissimilar quantitative and qualitative effects. The aim of the present experiments was to investigate: (a) the effect of thymopoietin fragments in mice with unbalanced immune systems caused by experimental manipulation; and (b) the ratio of target cells after treatment. The distribution of Thy1, Lyt1, Lyt2 positivity was determined in a direct complement mediated cytotoxicity test. Autoantibody production was measured by Coombs' test. A count of Lewis Lung Tumour (LLT) metastases was made after two weeks of inoculation. Groups of mice were thymectomized and/or injected with cyclophosphamide (CY) (240 mg/kg) 96 h before tumour cell inoculation. The number of LLT metastases was decreased by treatment with peptides (TP3 = 72, TP4 = 97, TP5[thymopoietin 32-36] = 83.1 in %) and immunosuppression produced by CY was partly restored. After thymectomy, however, only TP3 treatment caused a decreasing effect (97.4%) on CY immunotoxicity independently of thymectomy. Inhibition of autoantibody production was detected with TP3 (5-6 weeks earlier than in mice treated with TP5). The ratio of Thy1+ and Lyt2+ cells was increased by treatment with TP3 and TP4, but the ratio of Lyt1+ cells was decreased by application of TP5. After TP3 treatment of nude mice the Lyt1+/Lyt2+ ratio increased both in bone marrow and spleen. No effect of TP4 was observed on Lyt 1+ cells, but the number of Lyt2+ increased in bone marrow.(ABSTRACT TRUNCATED AT 250 WORDS)

Adjuvants, Immunologic↗
PubMed1987

Immune-mediated hemolytic anemia and thrombocytopenia in a foal.

A one-month-old Quarter Horse filly had unilateral epistaxis, hyphema, icterus, petechial hemorrhages in the oral, nasal, conjunctival, and vulvar mucous membranes, anemia, thrombocytopenia, negative antinuclear test result, and a positive direct Coombs' test result. Megakaryocytes or cell-associated IgG (fluorescent antibody and immunoperoxidase stains) were not found in bone marrow biopsy specimens. Treatment consisted of glucocorticoids, antibiotics, and a single whole blood transfusion. The foal responded well to treatment, did not develop relapses of the disease, and was clinically normal one year after treatment.

Anemia, Hemolytic, Autoimmune↗
PubMed1977

[Blood group compatibility testing for blood transfusions].

Acute and chronic dangers of blood-transfusion are listed. Three serologic demands in selecting donorblood are identity in the ABO-system compatibility in the Rh-system and a negative cross-match in the mode of a three-step Coombs-test. The often claimed consideration of the Kell-system is shown to be numerical in the background of transfusion-practice. The highest responsibility is taken by the physician in transfusing patients with Coombs-positive auto-immune-diseases in which the cross-match is positive and so present antibodies could be hidden.

ABO Blood-Group System↗
PubMed1967

Postthymectomy wasting associated with autoimmune phenomena. I. Antiglobulin-positive anemia in A and C57BL-6 Ks mice.

1. Mice of A and C(57)BL/6 Ks strains, thymectomized at birth acquire wasting disease in 84.1% (A) and 77.1% (C(57)BL/6 Ks) of the cases. There is no sex predelection. 2. Anemia in these animals is characterized by shortened red cell survival and increased fragility to hypotonic salt solutions. Among thymectomized A mice reticulocytosis is absent and extramedullary hematopoiesis is found in the spleen in the presence of bone marrow hypoplasia for the erythroid and lymphocyte series. 3. Positive antiglobulin tests of the red cells were observed in all the thymectomized C(57)BL/6 Ks (7/7) and 71.2% of the A strains (62/87). Normal mice do not show positive Coombs' tests. 4. The globulin coat on the A strain consists of IgM, whereas beta(1C) and IgG are not detectable. By contrast, red cell coats of NZB mice developing spontaneous autoimmune hemolytic anemia show IgM and beta(1C), but these erythrocytes do not react with anti-gamma chain antibodies. Another difference in the globulin coats of the two types of erythrocytes is that the IgM on NZB red cells has available light chain determinants but these are apparently hidden or absent in the case of sensitized erythrocytes. The difference in antibody coating, association with a component of complement in one but not the other, suggests a different mechanism for the immune surface phenomenon in each instance. 5. Anemia in NZB mice is associated with reticulocytosis while that in thymectomized A mice is not. 6. Thymectomy appears to initiate a chain of events leading to a series of autoimmune phenomena which may be due to alteration in host response consequent to loss of thymic tissue and thymic dependent functions or alternatively to infection to which increased susceptibility exists as a result of thymic extirpation.

Anemia, Hemolytic↗
PubMed1968

Immunoglobulins in NZB-BL mice. I. Serum immunoglobulin levels and immunoglobulin class of erythrocyte autoantibody.

Determination of serum immunoglobulin levels in NZB and normal mice has indicated that an elevation of the gammaM-globulin level occurs in NZB mice. This can be demonstrated in young NZB mice well before other autoimmune manifestations are observed. A slight elevation of gammaM-globulin was also observed in NZB hybrid mice. Erythrocyte autoantibodies were analyzed by the direct Coombs' test with specific antiimmunoglobulin reagents. Autoantibodies in NZB mice can be of all immunoglobulin classes, although predominantly of gammaG(1)-class. In (NZB x NZC)F(1) hybrid mice, although Coombs' positivity develops around the same age as in NZB mice, there is a greater restriction of the autoantibodies into gammaM- and gammaG(1)-classes. Preliminary attempts to quantitate immunoglobulins coating NZB red cells have shown that there are approximately 400 molecules of gammaM and 5000 molecules of gammaG-globulin per NZB mouse red cell.

Animals↗
PubMed1976

Reevaluation of the polyvinylpyrrolidone sedimentation test in the diagnosis of ABO hemolytic disease of the newborn.

The rate of cord erythrocytes sedimentation in 1.5% polyvinylpyrrolidone (PVP) solution was investigated. Of 70 infants showing accelerated sedimentation rate, 49 had signs of hemolytic disease. Rh incompatibility did not affect the sedimentation rate. Infectious diseases might cause a slight increase in the rate of sedimentation. The test was found to be very sensitive. It could detect ABO incompatibilities even in absence of marked bilirubinemia. Furthermore, positive identification of incompatibilities were obtained in ABO-HDN cases where both direct and indirect Coombs tests were negative. High correlation was noted between anti A and B titer of maternal sera and the accelerated sedimentation of newborn red blood cells. The erythrocytes sedimentation test in PVP (PVP-ESR test) is recommended for the early detection of cases in which the red cells are affected by IgG anti-A or anit-B.

ABO Blood-Group System↗
PubMed1978

ABO hemolytic disease of the newborn: evaluation of management and identification of racial and antigenic factors.

Data from 16,320 deliveries from two time periods were examined to compare the incidence of positive direct Coombs' tests and the number of exchange transfusions performed, using different methods of screening and treatment in each time period. Early routine screening revealed an eightfold increase in the number of Coombs-positive infants, while the combined effect of instituting early screening and the change from white light to special blue light phototherapy greatly diminihsed the number of exchange transfusions. In addition, data concerning racial and blood antigen factors in ABO hemolytic disease of the newborn (HDN) are compared, showing an increase in incidence but no increase in severity for black infants and infants with blood type B. Also, use of cord blood parameters in management of ABO HDN is discussed.

ABO Blood-Group System↗
PubMed1978

Immunologic cross-reactivity between penicillins and cephalosporins: a review.

Several approaches have been undertaken in the study of possible immunologic cross-reactivity between cephalosporins and penicillins. Although the chemical structures of these compounds are similar in several respects, there are distinct differences in their degradation and transformation. Various degrees of cross-reactivity of antibodies produced in response to administration of these drugs have been demonstrated both with test systems that measure IgG and IgM antibodies and with those that measure IgE antibodies. The clinical significance of immune responses to cephalosporins is best understood in regard to immunohematologic abnormalities: positive direct antiglobulin (Coombs') tests occur in only approximately 3% of patients receiving cephalosporins; however, several cases of cephalosporin-induced immune hemolytic anemia have been reported. Clinical studies of the cephalosporins indicated that patients with a history of penicillin allergy have increased incidence of reactivity to cephalosporins, but it is impossible to determine to what extent this finding is due to immunologic cross-reactivity because penicillin-allergic patients have an increased incidence of hypersensitivity reactions to drugs immunologically unrelated to penicillins. In addition, there is evidence of specific immune response to cephalosporins that indicates independently acquired hypersensitivity rather than cross-reactivity in some patients.

Anemia, Hemolytic, Autoimmune↗
PubMed1976

Antibody coated red cells with and without hemolysis in chronic ulcerative colitis.

A young female with ulcerative colitis associated with positive direct and indirect Coombs reaction and severe autoimmune hemolytic anemia is reported. Cortisone was beneficial and total colectomy was promptly followed by subsidence of the hematologic defects. Review of the literature suggests that this complication of ulcerative colitis is uncommon. It basis is unclear. It seems to be expressed through the presence of a "warm" auto-antibody. Colectomy should be strongly considered when severe hemolysis is present but not when the Coombs test is positive alone without significant hemolysis.

Adult↗
PubMed1971

Rhesus isoimmunization after abortion.

Out of 177 Rh(D)-negative patients studied, 96 were successfully followed-up after spontaneous or therapeutic abortion. Rh antibodies were detected by the indirect Coombs test in two patients and by an enzyme technique only in a further seven, an overall incidence of 9.4%.The prophylactic use of anti-D immunoglobulin is now recommended for Rh-negative non-immunized patients undergoing abortion, but the dose could be less than 75 mug. The Kleihauer test was of no value in predicting the risk of isoimmunization.

Abortion, Spontaneous↗