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November 25, 1992, Vol 268, No. 20 >
ARTICLE | November 25, 1992

Immunohematologic Diseases FREE

Lanny J. Rosenwasser, MD; Bobby Z. Joseph, MD
JAMA. 1992;268(20):2940-2945. doi:10.1001/jama.1992.03490200192024
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Article
References

TWO EVENTS revolutionized the field of immunohematology: the discovery of the ABO blood group system by Karl Landsteiner in 1900 and the development of the Coombs' test in 1945. These observations resulted in the improved safety and success of blood transfusions.

Approximately 2% of hospitalized patients develop alloantibodies that are formed as a result of blood transfusions from heterologous donors or during pregnancy; this can lead to transfusion reactions or hemolytic disease of the newborn. Although it was initially thought that alloantibodies are formed only against erythrocyte antigens, it became evident that alloantibodies are also generated against various neutrophil (eg, NA1, NB1) and platelet (eg, P1A1, Baka) antigens. Like erythrocyte alloantibodies, neutrophil and platelet alloantibodies can cause immune destruction of blood cells during transfusion reactions or pregnancy. Furthermore, immune destruction of erythrocytes, neutrophils, and platelets can occur when autoantibodies are produced against these cells, during drug therapy, or

REFERENCES

1 +
Sokol RJ, Hewitt S.  Autoimmune hemolysis: a critical review. Crit Rev Oncol Hematol . 1985;;4: 125-154.
2 +
Lalezari P.  Serologic profile in autoimmune hemolytic disease: pathophysiologic and clinical interpretations. Semin Hematol . 1976;;13:291-310.
3 +
Mollison PL, Crome P, Hughes Jones NC, Rochna E.  Rate of removal from the circulation of red cells sensitized with different amounts of antibody. Br J Haematol . 1965;;11:461-470.
4 +
Abramson N, Gelfand EW, Handl JH, Rosen FS.  The interaction between human monocytes and red cells: specificity for IgG subclasses and IgG fragments. J Exp Med . 1970;;132:1207-1215.
5 +
Huber H, Polley MJ, Linscott WD, Fudenberg HH, Muller-Eberhard HJ.  Human monocytes: distinct receptor sites for the third component of complement and for immunoglobulin G. Science . 1968;; 162:1281-1283.
6 +
LoBuglio AF, Cotran RS, Jandl JH.  Red cells coated with immunoglobulin G: binding and sphering by mononuclear cells in man. Science . 1967;;158: 1582-1585.
7 +
Evans RS, Takahashi K, Duane RT, et al.  Primary thrombocytopenic purpura and acquired hemolytic anemia: evidence for a common etiology. Arch Intern Med . 1951;;87:48-65.
8 +
Gilliland BC, Leddy JP, Vaughan JH.  The detection of cell-bound antibody on complement-coated human red cells. J Clin Invest . 1970;;49:898-906.
9 +
Atkinson JP, Schreiber AD, Frank MM.  Effects of corticosteroids and splenectomy on the immune clearance and destruction of erythrocytes. J Clin Invest . 1973;;52:1509-1517.
10 +
Rosse WF.  Quantitative immunology of immune hemolytic anemia, II: the relationship of cell-bound antibody to hemolysis and the effect of treatment. J Clin Invest . 1971;;50:734-744.
11 +
Nydegger UE, Kazatchkine MD, Miescher PA.  Immunopathologic and clinical features of hemolytic anemia due to cold agglutinins. Semin Hematol . 1991;;28:66-77.
12 +
Adinolfi M.  Anti-I antibody in normal human newborn infants. Immunology . 1965;;9:43-52.
13 +
Roelcke D.  Cold agglutination: antibodies and antigens. Clin Immunol Immunopathol . 1974;;2: 266-280.
14 +
Frank MM.  Complement: a brief review. J Allergy Clin Immunol . 1989;;84:411-420.
15 +
Jaffe J, Atkinson JP, Frank MM.  The role of complement in the clearance of cold agglutinin sensitized erythrocytes in man. J Clin Invest . 1976;; 58:942-949.
16 +
Worlledge SM, Rousso C.  Studies of the serology of paroxysmal cold haemoglobinuria with special reference to its relationship with P blood group system. Vox Sang . 1965;;10:293-298.
17 +
Petz LD, Branch DR.  Drug-induced hemolytic anemia.  In: Chaplin H, ed. Methods in Hematology: Immune Hemolytic Anemias . New York, NY: Churchill Livingstone Inc; 1985;:47-94.
18 +
Levine B, Redmond A.  Immunochemical mechanisms of penicillin-induced Coombs positivity and hemolytic anemia in man. Int Arch Allergy Appl Immunol . 1967;;31:594-606.
19 +
Petz LD, Fudenberg HH.  Coombs-positive hemolytic anemia caused by penicillin administration. N Engl J Med . 1966;;274:171-178.
20 +
LoBuglio AF, Jandl JH.  The nature of alphamethyldopa red cell antibody. N Engl J Med . 1967;; 276:658-665.
21 +
Carstairs KC, Breckenridge A, Dollery CT, Worlledge SM.  Incidence of a positive direct Coombs test in patients on alpha-methyldopa. Lancet . 1966;; 2:133-135.
22 +
Spath P, Garratty G, Petz L.  Studies on the immune response to penicillin and cephalothin in humans, II: immunohematologic reactions to cephalothin administration. J Immunol . 1971;;107:860-869.
23 +
Agre P, Carton JP.  Molecular biology of the Rh antigens. Blood . 1991;;78:551-563.
24 +
Desjardins L, Blajchman MA, Chintu C, Zipursky A.  The spectrum of ABO hemolytic disease of the newborn infant. J Pediatr . 1979;;95:447-449.
25 +
Bowman JM.  The prevention of Rh immunization. Transfusion Med Rev . 1988;;2:129-150.
26 +
George JN.  Platelet immunoglobulin G: its significance for the evaluation of thrombocytopenia and for understanding the origin of α granule proteins. Blood . 1990;;76:859-870.
27 +
Aster RH, Keene WR.  Sites of platelet destruction in idiopathic thrombocytopenic purpura. Br J Haematol . 1969;;16:61-73.
28 +
Ballem PJ, Segal GM, Stratton JR, et al.  Mechanisms of thrombocytopenia in chronic autoimmune thrombocytopenic purpura: evidence of both impaired platelet production and increased platelet clearance. J Clin Invest . 1987;;80:33-40.
29 +
Baldini MG.  Platelet production and destruction in idiopathic thrombocytopenic purpura: a controversial issue. JAMA . 1978;;239:2477-2479.
30 +
Puram V, Guiliani D, Morse BS.  Circulating immune complexes and platelet IgG in various diseases. Clin Exp Immunol . 1984;;58:672-676.
31 +
Kurata Y, Hayashi S, Aochi H, et al.  Analysis of antigen involved in circulating immune complexes in patients with idiopathic thrombocytopenic purpura. Clin Exp Immunol . 1987;;67:293-299.
32 +
McClure PD.  Idiopathic thrombocytopenic purpura in children: diagnosis and management. Pediatrics . 1975;;55:68-74.
33 +
DiFino SM, Lachant NA, Kirshner JJ, Gottlieb AJ.  Adult idiopathic thrombocytopenic purpura: clinical findings and response to therapy. Am J Med . 1980;;69:430-442.
34 +
Ahn YS, Harrington WJ, Mylvaganam R.  Immunosuppressant therapy of idiopathic thrombocytopenic purpura. Springer Semin Immunopathol . 1984;;7:35-42.
35 +
Stiehm ER.  IGIV in idiopathic thrombocytopenic purpura. Adv Pediatr . 1988;;35:50-52.
36 +
Kelton JG.  Management of the pregnant patient with idiopathic thrombocytopenic purpura. Ann Intern Med . 1983;;99:796-800.
37 +
Zon LI, Groopman JE.  Hematologic manifestations of the human immunodeficiency virus. Semin Hematol . 1988;;25:208-218.
38 +
Karpatkin S.  Immunologic thrombocytopenic purpura in HIV-seropositive homosexuals, narcotic addicts and hemophiliacs. Semin Hematol . 1988;; 25:219-229.
39 +
Pollak AN, Janinis J, Green D.  Successful intravenous immune globulin therapy for human immunodeficiency virus—associated thrombocytopenia. Arch Intern Med . 1988;;148:695-697.
40 +
Levine AB, Berkowitz RL.  Neonatal alloimmune thrombocytopenia. Semin Perinatol . 1991;; 15:35-40.
41 +
Yankee RA, Grumet FC, Rogentine GN.  Platelet transfusion therapy; the selection of compatible platelet donors for refractory patients by lymphocyte HLA typing. N Engl J Med . 1969;;281:1208-1212.
42 +
Minchinton RM, McGrath KM.  Alloimmune neonatal neutropenia: a neglected diagnosis? Med J Aust . 1987;;147:139-141.
43 +
van der Veen JP, Hack CE, Engelfriet CP, Pegels JG, von dem Borne AE.  Chronic idiopathic and secondary neutropenia: clinical and serological investigations. Br J Haematol . 1986;;63:161-171.
44 +
Vincent PC.  Drug-induced aplastic anemia and agranulocytosis: incidence and mechanisms. Drugs . 1986;;31:52-63.
45 +
Greenwalt TJ.  Pathogenesis and management of hemolytic transfusion reactions. Semin Hematol . 1981;;18:84-94.
46 +
Barton JC.  Nonhemolytic, noninfectious transfusion reactions. Semin Hematol . 1981;;18:95-121.
47 +
Schmidt AP, Taswell HF, Gleich GJ.  Anaphylactic transfusion reactions associated with anti-IgA antibody. N Engl J Med . 1969;;280:188-193.
48 +
Shulman NR, Aster RH, Leitner A, Hiller MC.  Immunoreactions involving platelets, V: post-transfusion purpura due to complement-fixing antibody against a genetically controlled platelet antigen—a proposed mechanism for thrombocytopenia and its relevance in 'autoimmunity.' J Clin Invest . 1961;; 40:1597-1620.
49 +
Anderson KC, Goodnough LT, Sayers M, et al.  Variation in blood component irradiation practice: implications for prevention of transfusion-associated graft versus host disease. Blood . 1991;;77:2096-2102.
50 +
Varga J, Griffin R, Newman JH, Jimenez SA.  Eosinophilic fasciitis is clinically distinguishable from eosinophilia-myalgia syndrome and is not associated with L-tryptophan use. J Rheumatol . 1991;;18: 259-263.
51 +
Martin RW, Duffy J, Engel AG, et al.  The clinical spectrum of the eosinophilia-myalgia syndrome associated with L-tryptophan ingestion: clinical features in 20 patients and aspects of pathophysiology. Ann Intern Med . 1990;;113:124-134.
52 +
Fauci AS, Harley JB, Roberts WC, et al.  The idiopathic hypereosinophilic syndrome: clinical pathophysiologic and therapeutic considerations. Ann Intern Med . 1982;;97:78-92.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Sokol RJ, Hewitt S.  Autoimmune hemolysis: a critical review. Crit Rev Oncol Hematol . 1985;;4: 125-154.
2 +
Lalezari P.  Serologic profile in autoimmune hemolytic disease: pathophysiologic and clinical interpretations. Semin Hematol . 1976;;13:291-310.
3 +
Mollison PL, Crome P, Hughes Jones NC, Rochna E.  Rate of removal from the circulation of red cells sensitized with different amounts of antibody. Br J Haematol . 1965;;11:461-470.
4 +
Abramson N, Gelfand EW, Handl JH, Rosen FS.  The interaction between human monocytes and red cells: specificity for IgG subclasses and IgG fragments. J Exp Med . 1970;;132:1207-1215.
5 +
Huber H, Polley MJ, Linscott WD, Fudenberg HH, Muller-Eberhard HJ.  Human monocytes: distinct receptor sites for the third component of complement and for immunoglobulin G. Science . 1968;; 162:1281-1283.
6 +
LoBuglio AF, Cotran RS, Jandl JH.  Red cells coated with immunoglobulin G: binding and sphering by mononuclear cells in man. Science . 1967;;158: 1582-1585.
7 +
Evans RS, Takahashi K, Duane RT, et al.  Primary thrombocytopenic purpura and acquired hemolytic anemia: evidence for a common etiology. Arch Intern Med . 1951;;87:48-65.
8 +
Gilliland BC, Leddy JP, Vaughan JH.  The detection of cell-bound antibody on complement-coated human red cells. J Clin Invest . 1970;;49:898-906.
9 +
Atkinson JP, Schreiber AD, Frank MM.  Effects of corticosteroids and splenectomy on the immune clearance and destruction of erythrocytes. J Clin Invest . 1973;;52:1509-1517.
10 +
Rosse WF.  Quantitative immunology of immune hemolytic anemia, II: the relationship of cell-bound antibody to hemolysis and the effect of treatment. J Clin Invest . 1971;;50:734-744.
11 +
Nydegger UE, Kazatchkine MD, Miescher PA.  Immunopathologic and clinical features of hemolytic anemia due to cold agglutinins. Semin Hematol . 1991;;28:66-77.
12 +
Adinolfi M.  Anti-I antibody in normal human newborn infants. Immunology . 1965;;9:43-52.
13 +
Roelcke D.  Cold agglutination: antibodies and antigens. Clin Immunol Immunopathol . 1974;;2: 266-280.
14 +
Frank MM.  Complement: a brief review. J Allergy Clin Immunol . 1989;;84:411-420.
15 +
Jaffe J, Atkinson JP, Frank MM.  The role of complement in the clearance of cold agglutinin sensitized erythrocytes in man. J Clin Invest . 1976;; 58:942-949.
16 +
Worlledge SM, Rousso C.  Studies of the serology of paroxysmal cold haemoglobinuria with special reference to its relationship with P blood group system. Vox Sang . 1965;;10:293-298.
17 +
Petz LD, Branch DR.  Drug-induced hemolytic anemia.  In: Chaplin H, ed. Methods in Hematology: Immune Hemolytic Anemias . New York, NY: Churchill Livingstone Inc; 1985;:47-94.
18 +
Levine B, Redmond A.  Immunochemical mechanisms of penicillin-induced Coombs positivity and hemolytic anemia in man. Int Arch Allergy Appl Immunol . 1967;;31:594-606.
19 +
Petz LD, Fudenberg HH.  Coombs-positive hemolytic anemia caused by penicillin administration. N Engl J Med . 1966;;274:171-178.
20 +
LoBuglio AF, Jandl JH.  The nature of alphamethyldopa red cell antibody. N Engl J Med . 1967;; 276:658-665.
21 +
Carstairs KC, Breckenridge A, Dollery CT, Worlledge SM.  Incidence of a positive direct Coombs test in patients on alpha-methyldopa. Lancet . 1966;; 2:133-135.
22 +
Spath P, Garratty G, Petz L.  Studies on the immune response to penicillin and cephalothin in humans, II: immunohematologic reactions to cephalothin administration. J Immunol . 1971;;107:860-869.
23 +
Agre P, Carton JP.  Molecular biology of the Rh antigens. Blood . 1991;;78:551-563.
24 +
Desjardins L, Blajchman MA, Chintu C, Zipursky A.  The spectrum of ABO hemolytic disease of the newborn infant. J Pediatr . 1979;;95:447-449.
25 +
Bowman JM.  The prevention of Rh immunization. Transfusion Med Rev . 1988;;2:129-150.
26 +
George JN.  Platelet immunoglobulin G: its significance for the evaluation of thrombocytopenia and for understanding the origin of α granule proteins. Blood . 1990;;76:859-870.
27 +
Aster RH, Keene WR.  Sites of platelet destruction in idiopathic thrombocytopenic purpura. Br J Haematol . 1969;;16:61-73.
28 +
Ballem PJ, Segal GM, Stratton JR, et al.  Mechanisms of thrombocytopenia in chronic autoimmune thrombocytopenic purpura: evidence of both impaired platelet production and increased platelet clearance. J Clin Invest . 1987;;80:33-40.
29 +
Baldini MG.  Platelet production and destruction in idiopathic thrombocytopenic purpura: a controversial issue. JAMA . 1978;;239:2477-2479.
30 +
Puram V, Guiliani D, Morse BS.  Circulating immune complexes and platelet IgG in various diseases. Clin Exp Immunol . 1984;;58:672-676.
31 +
Kurata Y, Hayashi S, Aochi H, et al.  Analysis of antigen involved in circulating immune complexes in patients with idiopathic thrombocytopenic purpura. Clin Exp Immunol . 1987;;67:293-299.
32 +
McClure PD.  Idiopathic thrombocytopenic purpura in children: diagnosis and management. Pediatrics . 1975;;55:68-74.
33 +
DiFino SM, Lachant NA, Kirshner JJ, Gottlieb AJ.  Adult idiopathic thrombocytopenic purpura: clinical findings and response to therapy. Am J Med . 1980;;69:430-442.
34 +
Ahn YS, Harrington WJ, Mylvaganam R.  Immunosuppressant therapy of idiopathic thrombocytopenic purpura. Springer Semin Immunopathol . 1984;;7:35-42.
35 +
Stiehm ER.  IGIV in idiopathic thrombocytopenic purpura. Adv Pediatr . 1988;;35:50-52.
36 +
Kelton JG.  Management of the pregnant patient with idiopathic thrombocytopenic purpura. Ann Intern Med . 1983;;99:796-800.
37 +
Zon LI, Groopman JE.  Hematologic manifestations of the human immunodeficiency virus. Semin Hematol . 1988;;25:208-218.
38 +
Karpatkin S.  Immunologic thrombocytopenic purpura in HIV-seropositive homosexuals, narcotic addicts and hemophiliacs. Semin Hematol . 1988;; 25:219-229.
39 +
Pollak AN, Janinis J, Green D.  Successful intravenous immune globulin therapy for human immunodeficiency virus—associated thrombocytopenia. Arch Intern Med . 1988;;148:695-697.
40 +
Levine AB, Berkowitz RL.  Neonatal alloimmune thrombocytopenia. Semin Perinatol . 1991;; 15:35-40.
41 +
Yankee RA, Grumet FC, Rogentine GN.  Platelet transfusion therapy; the selection of compatible platelet donors for refractory patients by lymphocyte HLA typing. N Engl J Med . 1969;;281:1208-1212.
42 +
Minchinton RM, McGrath KM.  Alloimmune neonatal neutropenia: a neglected diagnosis? Med J Aust . 1987;;147:139-141.
43 +
van der Veen JP, Hack CE, Engelfriet CP, Pegels JG, von dem Borne AE.  Chronic idiopathic and secondary neutropenia: clinical and serological investigations. Br J Haematol . 1986;;63:161-171.
44 +
Vincent PC.  Drug-induced aplastic anemia and agranulocytosis: incidence and mechanisms. Drugs . 1986;;31:52-63.
45 +
Greenwalt TJ.  Pathogenesis and management of hemolytic transfusion reactions. Semin Hematol . 1981;;18:84-94.
46 +
Barton JC.  Nonhemolytic, noninfectious transfusion reactions. Semin Hematol . 1981;;18:95-121.
47 +
Schmidt AP, Taswell HF, Gleich GJ.  Anaphylactic transfusion reactions associated with anti-IgA antibody. N Engl J Med . 1969;;280:188-193.
48 +
Shulman NR, Aster RH, Leitner A, Hiller MC.  Immunoreactions involving platelets, V: post-transfusion purpura due to complement-fixing antibody against a genetically controlled platelet antigen—a proposed mechanism for thrombocytopenia and its relevance in 'autoimmunity.' J Clin Invest . 1961;; 40:1597-1620.
49 +
Anderson KC, Goodnough LT, Sayers M, et al.  Variation in blood component irradiation practice: implications for prevention of transfusion-associated graft versus host disease. Blood . 1991;;77:2096-2102.
50 +
Varga J, Griffin R, Newman JH, Jimenez SA.  Eosinophilic fasciitis is clinically distinguishable from eosinophilia-myalgia syndrome and is not associated with L-tryptophan use. J Rheumatol . 1991;;18: 259-263.
51 +
Martin RW, Duffy J, Engel AG, et al.  The clinical spectrum of the eosinophilia-myalgia syndrome associated with L-tryptophan ingestion: clinical features in 20 patients and aspects of pathophysiology. Ann Intern Med . 1990;;113:124-134.
52 +
Fauci AS, Harley JB, Roberts WC, et al.  The idiopathic hypereosinophilic syndrome: clinical pathophysiologic and therapeutic considerations. Ann Intern Med . 1982;;97:78-92.

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