SEVERE ERYTHROBLASTOSIS FETALIS IN FIRST IMMUNIZED PREGNANCIES.
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The composition of immunoglobulins in patients with brucellosis was studied. The method of ion-exchange chromatography on DEAE-cellulose columns was used to define more precisely the physico-chemical character of cysteine-resistant antibodies. The study of IgM, IgA and IgG fractions obtained from the patients sera showed the IgG fraction to possess the greatest serological activity in the agglutination reaction, in the passive haemagglutination reaction and in Coomb's test. Specific antibodies in the remaining 2 fractions (IgA and IgM) were found only in single patients in low titres, mainly in Coomb's test (incomplete antibodies). The study of IgM, IgA and IgG serum fractions before and after cysteine treatment revealed cysteine-resistant antibodies to be usually IgG globulins. The presence of specific IgG antibodies in the sera of patients was found to correlate with active clinical manifestations of brucellosis.
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The direct antiglobulin consumption (DAC) test, used for the detection of platelet autoantibodies, was found to be positive in 86% of a group of 150 patients with thrombocytopenic purpura. The platelet radioactive Coombs' (DRC) test was performed in 30 patients and the correlation between the two tests was statistically significant (r = 0.48, p less than 0.01). The two tests were used in an indirect mode for the detection of antiplatelet antibodies in serum. The results of the two tests were in good agreement (r = 0.06, p less than 0.001). There was not a statistically significant correlation between the level of platelet-associated IgG and the presence of platelet antibodies in the serum. These results indicate that the DAC test or DRC test can be used interchangeably for the detection of antibody in serum or of antibody bound to platelets, and that only the direct test, using the patients' platelets, is useful in the diagnosis of autoimmune thrombocytopenic purpura.
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The clinical and laboratory features of a case of alphamethyldopa-induced thrombocytopenia are described. This is the second reported case in which the presence of alpha-methyldopa-induced platelet antibodies have been demonstrated.
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