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ARTICLE |

Immunohematologic Disorders FREE

Alan Winkelstein, MD; Joseph E. Kiss, MD
JAMA. 1997;278(22):1982-1992. doi:10.1001/jama.1997.03550220188024
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Immunohematology encompasses a broad array of clinical disorders in which immune reactions are involved in the pathogenesis of hematologic diseases. Immune reactions can involve the formed elements of the blood, producing hemolytic anemia, thrombocytopenia, or neutropenia. Autoimmune phenomena and drug-induced reactions are the most common mechanisms. In newborns, maternal antibodies can cross the placenta and destroy red blood cells, platelets, or neutrophils. Immune reactions can also occur during transfusion of blood products, leading to hemolysis, febrile reactions, allergic reactions, and lung injury. The role of leukocytes and cytokines released during blood component storage in mediating febrile transfusion reactions has prompted the increased use of leukocyte-reduced components. Immune reactions can occur to soluble clotting factors and can produce bleeding or thrombosis. Finally, immunohematologic features of B-cell disorders are considered.

REFERENCES

Frank MM.  Complement: a brief review . J Allergy Clin Immunol . 1989;;84:411-420.
Judd WJ, Barnes BA, Steiner EA, et al.  The evaluation of a positive direct antiglobulin test (autocontrol) in pretransfusion testing revisited . Transfusion . 1986;;26:220-224.
Molthan L, Reidenberg MM, Eichman MF.  Positive direct Coombs test due to cephalothifl . N Engl J Med . 1967;;277:123-125.
Heddle NM, Kelton JG, Turchyn KL, et al.  Hypergammaglobulinemia can be associated with a positive direct antiglobulin test, a nonreactive eluate, and no evidence of hemolysis . Transfusion . 1988;;28:29-33.
Grindon AJ, Wilson MJ.  False-positive DAT caused by variables in sample procurement . Transfusion . 1981;;21:313-315.
Hamblin TJ, Oscier TJ, Young BJ, et al.  Autoimmunity in chronic lymphocytic leukaemia . J Clin Pathol . 1986;;39:713-716.
 Identification of unexpected alloantibodies . In: Walker RH, ed. Technical Manual . Arlington, Va: American Association of Blood Banks; 1990;:293-313.
Engelfriet CP, Overbeeke MAM, von dem Borne AEG Kr, et al.  Autoimmune hemolytic anemia . Semin Hematol . 1992;;29:3-12.
Nydegger UE, Kazatchkine MD, Miescher PA, et al.  Immunopathologic and clinical features of hemolytic anemia due to cold agglutinins . Semin Hematol . 1991;;28:66-77.
Engelfriet CP, Overbeeke MAM, Dooren MC, et al.  Bioassays to determine the clinical significance of red cell alloantibodies based on Fc receptor-induced destruction of red cells sensitized by IgG . Transfusion . 1994;;34:617-626.
Petz LD, Garratty G. Acquired Immune Hemolytic Anemias . New York, NY: Churchill Livingstone; 1980;.
Gilliland BC, Baxter E, Evans RS.  Red cell antibodies in acquired hemolytic anemia with negative antiglobulin serum tests . N Engl J Med . 1971;;285:252-256.
Pirofsky B.  Clinical aspects of autoimmune hemolytic anemia . Semin Hematol . 1976;;13:251-264.
Flores G, Cunningham-Rundles C, Newland AC, et al.  Efficacy of intravenous immunoglobulin in the treatment of autoimmune hemolytic anemia: results in 73 patients . Am J Hematol . 1993;;44:237-242.
Ness PM.  Autoimmune hemolytic anemia . In: Brain MC, Carbone PP, ed. Current Therapy in Hematology-Oncology . Philadelphia, Pa: BC Decker; 1992;:25-28.
Sokol RJ, Booker DJ, Stamps R, et al.  The pathology of autoimmune haemolytic anemia . J Clin Pathol . 1992;;45:1047-1052.
Pruzanski W, Shumak KH.  Biologic activity of cold-reacting autoantibodies (second of two parts) . N Engl J Med . 1977;;297:583-589.
Hippe E, Jenson KB, Olesen H, et al.  Chlorambucil treatment of patients with cold agglutinin syndrome . Blood . 1970;;35:68-72.
Petz LD.  Drug-induced autoimmune hemolytic anemia . Transfus Med Rev . 1993;;7:242-254.
Garratty G.  Immune cytopenias associated with antibiotics . Transfus Med Rev . 1993;;7:255-267.
Garratty G, Nance S, Lloyd M, et al.  Fatal immune hemolytic anemia due to cefotetan . Transfusion . 1992;;32:269-271.
Dhawan M, Kiss JE, DiAddezzio NA, et al.  Fatal cefotetan-induced immune hemolysis . Blood . 1993;;82:582a.
Bowman JM.  Intrauterine transfusion . In: Anderson KC, Ness PM, eds. Scientific Basis of Transfusion Medicine: Implications for Clinical Practice . Philadelphia, Pa: WB Saunders Co; 1994;; 4:403-420.
Judd WJ, Luban NLC, Ness PM, et al.  Prenatal and perinatal immunohematology: recommendations for serologic management of the fetus, newborn infant, and obstetric patient . Transfusion . 1990;;30:175-183.
Chitkara U, Wilkins I, Lynch L, et al.  The role of sonography in assessing the severityof fetal anemia in Rh- and Kell-isoimmunized pregnancies . Obstet Gynecol . 1993;;71:393-398.
Queenan JT, Tomai TP, Ural SH, et al.  Deviation in amniotic fluid optic density of a wavelength of 450 nm in Rh-immunized pregnancies from 14to40weeks of gestation: a proposal for clinic management . Am J Obstet Gynecol . 1993;;168:1370-1376.
Fisk NC, Bennett P, Warwick RM, et al.  Clinical utility of fetal RhD typing in alloimmunized pregnancies by means of polymerase chain reaction or aminocytes or chorionic villi . Am J Obstet Gynecol . 1994;;171:50-54.
Rübo J, Albrecht K, Lasch P, et al.  High-dose intravenous immune globulin therapy for hyperbilirubinemia caused by Rh hemolytic disease . J Pediatr . 1992;;121:93-97.
Bowman JM.  Antenatal suppression of Rh alloimmunization . Clin Obstet Gynecol . 1991;;34:296-303.
Bussel JB.  Autoimmune thrombocytopenic purpura . Hematol Oncol Clin North Am . 1990;;4:179-191.
Waters AH.  Autoimmune thrombocytopenia: clinical aspects . Semin Hematol . 1992;;29:18-25.
Kiefel V, Freitag E, Kroll H, et al.  Platelet autoantibodies (IgG, IgM, IgA) against glycoproteins IIb/ IIIa and Ib/IX in patients with thrombocytopenia . Ann Hematol . 1996;;72:280-285.
George JN, Woolf SH, Raskob GE, et al.  Idiopathic thrombocytopenic purpura: a practical guideline developed by explicit methods for the American Society of Hematology . Blood . 1996;;88:3-40.
Schulman I.  Idiopathic (immune) thrombocytopenic purpura in children: pathogenesis and treatment . Pediatr Rev . 1983;;5:173-178.
Walker RW, Walker W.  Idiopathic thrombocytopenia: initial illness and long term follow-up . Arch Dis Child . 1984;;59:316-322.
Blanchette VS, Luke B, Andrew M, et al.  A prospective, randomized trial of high-dose intravenous immune globulin G therapy, oral prednisone therapy, and no therapy in childhood acute immune thrombocytopenic purpura . J Pediatr . 1993;;123:989-995.
Kaden BR, Rosse WF, Hauch TW.  Immune thrombocytopenia in lymphoproliferative diseases . Blood . 1979;;53:545-551.
den Ottolander GJ, Gratama JW, de Koning J, Brand A.  Long-term follow-up study of 168 patients with immune thrombocytopenia: implications for therapy . Scand J Haematol . 1984;;32:101-110.
Pizzuto J, Ambriz R.  Therapeutic experience on 934 adults with idiopathic thrombocytopenic purpura: multicentric trial of cooperative Latin American Group on Hemostasis and Thrombosis . Blood . 1984;;64:1179-1183.
Law C, Marcaccio M, Tam P, et al.  High-dose intravenous immune globulin and the response to splenectomy in patients with idiopathic thrombocytopenic purpura . N Engl J Med . 1997;;336:1494-1498.
Bussel JB, Girariano JN, Kimberly RP, et al.  IV anti-D treatment of immune thrombocytopenic purpura: analysis of efficacy, toxicity, and mechanism of effect . Blood . 1991;;77:1984-1893.
Oksenhendler E, Seligmann M.  HIV-related thrombocytopenia . Immunodefic Rev . 1990;;2:221-231.
Gonzalez-Conejero R, Rivera J, Rosillo MC, et al.  Association of autoantibodies against platelet glycoproteins Ib/IX and IIb/IIIa, and platelet-reactive anti-HIV antibodies in thrombocytopenic narcotic addicts . Br J Haematol . 1996;;93:464-471.
Karpatkin S, Nardi MA, Hymes KB.  Sequestration of antiplatelet GpIIIa antibody in rheumatoid factor immune complexes of human immunodeficiency virus 1 thrombocytopenic patients . Proc Nati Acad Sci U S A . 1995;;92:2263-2267.
Kouri YH, Borkowsky W, Nardi M, et al.  Human megakaryocytes have a CD4 molecule capable of binding human immunodeficiency virus-1 . Blood . 1993;;81:2664-2670.
Hoxie JA.  Hematologic manifestations of AIDS . In: Hoffman R, Bunz EJ, Shattil SJ, et al, eds. Hematology: Basic Principles and Practice . New York, NY: Churchill-Livingstone; 1995;:2171-2200.
Chong BH, Du X, Berndt MC, et al.  Characterization of the binding domains on platelet glycoproteins Ib-IX and IIb/IIIa complexes for the quinine/ quinidine-dependent antibodies . Blood . 1991;;77:2190-2199.
Hackett T, Kelton JG, Powers P.  Drug-induced platelet destruction . Semin Thromb Hemost . 1982;;8:116-137.
Warkentin TE, Kelton JG.  Heparin-inducedthrombocytopenia . Prog Hemost Thromb . 1991;;10:1-34.
Warkentin TE, Kelton JG.  Interaction of heparin with platelets, including heparin-induced thrombocytopenia . In: Bounameaux H, ed. Low-Molecular Weight Heparins in Prophylaxis and Therapy of Thromboembolic Diseases . New York, NY: Marcel Dekker; 1994;:75.
Kelton JG, Smith JW, Warkentin TE, et al.  Immunoglobulin G from patients with heparin-induced thrombocytopenia binds to a complex of heparin and platelet factor 4 . Blood . 1994;;83:3232-3239.
Warkentin TE, Hayward CPM, Boshkov LK, et al.  Sera from patients with heparin-induced thrombocytopenia generate platelet-derived microparticles with procoagulant activity: an explanation for the thrombotic complications of heparin-induced thrombocytopenia . Blood . 1994;;84:3691-3699.
Bussel JB, Zabusky MR, Berkowitz RL, et al.  Fetal alloimmune thrombocytopenia . N Engl J Med . 1997;;337:22-26.
Newman PJ, Derbes RS, Aster RH.  The human platelet alloantigens PlA1 and PlA2, are associated with a leucine33/proline33 amino acid polymorphism in membrane glycoprotein IIIA, and are distinguishable by DNA typing . J Clin Invest . 1989;;83:1778-1781.
Suarez CR, Anderson C.  High-dose intravenous gammaglobulin (IVG) in neonatal immune thrombocytopenia . Am J Hematol . 1987;;26:247-253.
McFarland JG, Aster RH, Bussel JB, et al.  Prenatal diagnosis of neonatal alloimmune thrombocytopenia using allele-specific oligonucleotide probes . Blood . 1991;;78:2276-2282.
Bussel JB, Berkowitz RL, Lynch L, et al.  Antenatal management of alloimmune thrombocytopenia with intravenous gamma-globulin: a randomized trial of the addition of low-dose steroid to intravenous gamma-globulin . Am J Obstet Gynecol . 1996;;174:1414-1423.
Bux J, Mueller-Eckhardt C.  Autoimmune neutropenia . Semin Hematol . 1992;;29:45-53.
Sasama K.  Reports of 355 transfusion-associated deaths: 1976 through 1985 . Transfusion . 1990;;30:583-590.
Linden JV, Paul B, Dressler KP.  A report of 104 transfusion errors in New York State . Transfusion . 1992;;32:601-606.
Capon SM, Goldfinger D.  Acute hemolytic transfusion reaction, a paradigm of two systemic inflammatory responses: new insights into pathophysiology and treatment . Transfusion . 1995;;35:513-520.
Davenport RD, Strieler RM, Kunkel SL.  Red cell ABO incompatibility and production of tumor necrosis factor-alpha . Br J Haematol . 1991;;78:540-544.
Butler J, Parker D, Pillai R, et al.  Systemic release of neutrophil elastase and tumor necrosis factor alpha following ABO incompatible blood transfusion . Br J Haematol . 1991;;79:525-526.
Pineda AA, Tuswell HF, Brzic SM Jr.  Delayed hemolytic transfusion reaction: an immunologic hazard of blood transfusion . Transfusion . 1978;;18:1-7.
Kevy SV, Schmidt PJ, McGinnis MH, et al.  Febrile, nonhemolytic transfusion reactions and the limited role of leukoagglutinins in their etiology . Transfusion . 1962;;2:7-16.
Heddle NM, Klama LN, Griffin L, et al.  A prospective study to identify risk factors associated transfusion reactions with acute reactions to platelet and red cell transfusions . Transfusion . 1993;;33:794-797.
Dzik W.  Is the febrile response to transfusion due to donor or recipient cytokine? Transfusion . 1992;;32:594.
Muylle L, Joos M, Wourters E, et al.  Increased tumor necrosis factor alpha, interleukin-1, and interleukin-6 levels in plasma of stored platelet concentrates: relationship between TNF alpha and IL-6 levels and febrile transfusion reactions . Transfusion . 1993;;33:195-199.
Heddle NM, Klama LN, Singer J, et al.  The role of plasma from platelet concentrates in transfusion reactions . N Engl J Med . 1994;;331:625-628.
Aye MT, Palmer DS, Giulivi A, et al.  Effect of filtration of platelet concentrates on the accumulation of cytokines and platelet release factors during storage . Transfusion . 1995;;35:117-124.
Stephen CR, Martin RC, Bourgeois-Gavardin M.  Antihistaminic drugs in treatment of nonhemolytic transfusion reactions . JAMA . 1955;;152:525-529.
Sandler SG, Mallory D, Alamut, et al.  IgA anaphylactic transfusion reactions . Transfus Med Rev . 1995;;9:1-8.
Bjerrum OJ, Jersild C.  Class-specificanti-IgA associated with severe anaphylactic transfusion reactions in a patient with pernicious anemia . Vox Sang . 1971;;21:411-424.
Popovsky MA, Moore SB.  Diagnostic and pathogenic considerations in transfusion- related acute lung injury . Transfusion . 1985;;25:573-577.
Popovsky MA, Chaplin HC, Moore SB.  Transfusion-related acute lung injury: a neglected, serious complication of hemotherapy . Transfusion . 1992;;32:589-592.
Anderson KC, Weinstein HJ.  Transfusion-associated graft-versus-host disease . N Engl J Med . 1989;;323:15-21.
Thaler M, Shamuss A, Aorgad S, et al.  The role of blood from HLA-homozygous donors in fatal transfusion-associated graft-versus-host disease after open heart surgery . N Engl J Med . 1989;;321:25-28.
Klein HG, ed. Standards for Blood Banks and Transfusion Services . 17th ed. Bethesda, Md: American Association of Blood Banks; 1996;.
Przepiorka D, LePark GF, Stovall MA, et al.  Use of irradiated blood components: practice parameter . Am J Clin Pathol . 1996;;106:6-11.
Mueller-Eckhardt C, Keefel V.  High dose IgG for post-transfusion purpura-revisited . Br J Haematol . 1988;;57:163-167.
Ehrenfort S, Kreuz W, Scharrer I, et al.  Incidence of development of factor VIII and factor IX inhibitors in hemophiliacs . Lancet . 1992;;339:594-598.
Robert SHR, Sallah S.  Immunology of inhibitors to clotting factors with emphasis on FVIII . In: Silberstein LE, ed. Autoimmune Disorders of Blood . Bethesda, Md: American Association of Blood Banks; 1996;:151-170.
Brettler DB, Forseberg AD, Levine PH, et al.  The use of porcine factor VIII concentrates (Hyate: C) in the treatment of patients with inhibitor antibodies to FVIII: multicenter US experience . Arch Intern Med . 1989;;149:1381-1385.
Sultan Y, Maisonneuve P, Kazatchkine MD, Nydegger UE.  Anti-idiotypic suppression of autoantibodies to factor VIII (anti-haemophilic factor) by high-dose intravenous gammaglobulin . Lancet . 1984;;2:765-768.
Permpikul P, Rao LV, Rapaport SI.  Functional and binding studies of the roles of prothrombin and β2-glycoprotein I in the expression of lupus anticoagulant activity . Blood . 1994;;83:2878-2892.
Canoso RT, de Oliveira RM.  Chlorpromazine-induced lupus anticoagulant anticardiolipin antibodies and lupus anticoagulant: absence of thrombosis . Am J Hematol . 1988;;27:272-275.
Schleider MA, Nachman RL, Jaffe EA, et al.  A clinical study of the lupus anticoagulant . Blood . 1976;;48:499-509.
Love PE, Santoro SA.  Antiphospholipid antibodies: anticardiolipin and the lupus anticoagulant in systemic lupus erythematosus (SLE) and in non-SLE disorders . Ann Intern Med . 1990;;112:682-698.
Lechner K, Pabinger-Fasching I.  Lupus anticoagulant and thrombosis: a study of 25 cases and review of the literature . Hemostasis . 1985;;15:254-262.
Asherson RA, Khamashta MA, Gill A, et al.  Cerebrovascular disease and antiphospholipid antibodies in systemic lupus erthematosus, lupus-like disease, and the primary antiphospholipid syndrome . Am J Med . 1989;;86:391-399.
Galli M, Finazzi G, Barbui T.  Thrombocytopenia in the antiphospholipid syndrome . Br J Haematol . 1996;;93:1-5.
Harris EN, Asherson RA, Hughes GRV.  Antiphospholipid antibodies: autoantibodies with a difference . Annu Rev Med . 1988;;39:261-271.
Triplett DA, Brandt JT, Musgrave KA, Orr CA.  The relationship between lupus anticoagulants and antibodies to phospholipid . JAMA . 1988;;259:550-554.
Cowchock S.  Autoantibodies and pregnancy loss . N Engl J Med . 1997;;337:197-198.
Laskin CA, Bombardier C, Hannah ME, et al.  Prednisone and aspirin in women with autoantibodies and unexplained recurrent fetal loss . N Engl J Med . 1997;;337:148-153.
Rosove MH, Tabsh K, Wasserstrum N, et al.  Heparin therapy for pregnant women with lupus anticoagulants or anticardiolipin antibodies . Obstet Gynecol . 1990;;75:630-634.
Mangan KF, Chikkappa G, Farley PC.  T gamma cells suppress growth of erythroid colony-forming units in vitro in the pure red cell aplasia of B-cell chronic lymphocytic leukemia . J Clin Invest . 1982;;70:1148-1156.
Chapel H, Bunch C.  Mechanisms of infections in chronic lymphocytic leukemia . Semin Hematol . 1987;;24:291-296.
Kurec AS, Threatte GA, Gottlieb AJ, et al.  Immunophenotypic subclassification of chronic lymphocytic leukemia (CLL) . Br J Haematol . 1992;;81:45-51.
Kay NE.  Abnormal T-cell subpopulation function in CLL: excessive suppressor (T) and deficient helper (T) activity with respect to B-cell proliferation . Blood . 1981;;57:418-420.
Vartersian ML.  Biologic and clinical advances in multiple myeloma . Oncology . 1995;;9:417-424.
Kyle RA, Greipp PR.  The laboratory investigation of monoclonal gammopathies . Mayo Clin Proc . 1978;;53:719-739.
Klein B, Zhang XG, Lu ZY, et al.  Interleukin-6 in human multiple myeloma . Blood . 1995;;85:863-873.
Kyle RA, Lust JA.  Monoclonal gammopathies of undetermined significance . Semin Hematol . 1989;;26:176-200.
Crawford J, Cox EB, Cohen JH.  Evaluation of hyperviscosity in monoclonal gammopathies . Am J Med . 1985;;79:13-22.
Kantarjian HM, Redman JR, Keating MJ.  Fludarabine phosphate therapy in other lymphoid malignancies . Semin Oncol . 1990;;17( (suppl 8) ):66-70.
Gertz MA, Li C-Y, Shirahama T, Kyle RA.  Utility of subcutaneous fat aspiration for the diagnosis of systemic amyloidosis (immunoglobin light chain) . Arch Intern Med . 1988;;148:929-933.
Greipp PR, Kyle RA, Bowie EJW.  Factor-X deficiency in amylodosis: a critical review . Am J Hematol . 1981;;11:443-450.
Holmgren G, Ericzon BG, Groth CG, et al.  Clinical improvement and amyloid regression after liver transplantation in hereditary transthyretin amyloidosis . Lancet . 1993;;341:1113-1116.
Sipe J D.  Amyloidosis . Annu Rev Biochem . 1992;;61:947-975.
Levo Y, Gorevic PD, Kassab JH, et al.  Association between hepatitis B virus and essential mixed cryoglobulinemia . N Engl J Med . 1977;;296:1501-1504.
Pascual M, Perrin L, Giostra E,et al.  Hepatitis C virus in patients with cryoglobulinemia type II . J Infect Dis . 1990;;162:569-570.
Ferri C, Marzo E, Longombardo G, et al.  Interferon-α in mixed cryoglobulinemia patients: a randomized, crossover-controlled trial . Blood . 1993;;81:1132-1136.

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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

Frank MM.  Complement: a brief review . J Allergy Clin Immunol . 1989;;84:411-420.
Judd WJ, Barnes BA, Steiner EA, et al.  The evaluation of a positive direct antiglobulin test (autocontrol) in pretransfusion testing revisited . Transfusion . 1986;;26:220-224.
Molthan L, Reidenberg MM, Eichman MF.  Positive direct Coombs test due to cephalothifl . N Engl J Med . 1967;;277:123-125.
Heddle NM, Kelton JG, Turchyn KL, et al.  Hypergammaglobulinemia can be associated with a positive direct antiglobulin test, a nonreactive eluate, and no evidence of hemolysis . Transfusion . 1988;;28:29-33.
Grindon AJ, Wilson MJ.  False-positive DAT caused by variables in sample procurement . Transfusion . 1981;;21:313-315.
Hamblin TJ, Oscier TJ, Young BJ, et al.  Autoimmunity in chronic lymphocytic leukaemia . J Clin Pathol . 1986;;39:713-716.
 Identification of unexpected alloantibodies . In: Walker RH, ed. Technical Manual . Arlington, Va: American Association of Blood Banks; 1990;:293-313.
Engelfriet CP, Overbeeke MAM, von dem Borne AEG Kr, et al.  Autoimmune hemolytic anemia . Semin Hematol . 1992;;29:3-12.
Nydegger UE, Kazatchkine MD, Miescher PA, et al.  Immunopathologic and clinical features of hemolytic anemia due to cold agglutinins . Semin Hematol . 1991;;28:66-77.
Engelfriet CP, Overbeeke MAM, Dooren MC, et al.  Bioassays to determine the clinical significance of red cell alloantibodies based on Fc receptor-induced destruction of red cells sensitized by IgG . Transfusion . 1994;;34:617-626.
Petz LD, Garratty G. Acquired Immune Hemolytic Anemias . New York, NY: Churchill Livingstone; 1980;.
Gilliland BC, Baxter E, Evans RS.  Red cell antibodies in acquired hemolytic anemia with negative antiglobulin serum tests . N Engl J Med . 1971;;285:252-256.
Pirofsky B.  Clinical aspects of autoimmune hemolytic anemia . Semin Hematol . 1976;;13:251-264.
Flores G, Cunningham-Rundles C, Newland AC, et al.  Efficacy of intravenous immunoglobulin in the treatment of autoimmune hemolytic anemia: results in 73 patients . Am J Hematol . 1993;;44:237-242.
Ness PM.  Autoimmune hemolytic anemia . In: Brain MC, Carbone PP, ed. Current Therapy in Hematology-Oncology . Philadelphia, Pa: BC Decker; 1992;:25-28.
Sokol RJ, Booker DJ, Stamps R, et al.  The pathology of autoimmune haemolytic anemia . J Clin Pathol . 1992;;45:1047-1052.
Pruzanski W, Shumak KH.  Biologic activity of cold-reacting autoantibodies (second of two parts) . N Engl J Med . 1977;;297:583-589.
Hippe E, Jenson KB, Olesen H, et al.  Chlorambucil treatment of patients with cold agglutinin syndrome . Blood . 1970;;35:68-72.
Petz LD.  Drug-induced autoimmune hemolytic anemia . Transfus Med Rev . 1993;;7:242-254.
Garratty G.  Immune cytopenias associated with antibiotics . Transfus Med Rev . 1993;;7:255-267.
Garratty G, Nance S, Lloyd M, et al.  Fatal immune hemolytic anemia due to cefotetan . Transfusion . 1992;;32:269-271.
Dhawan M, Kiss JE, DiAddezzio NA, et al.  Fatal cefotetan-induced immune hemolysis . Blood . 1993;;82:582a.
Bowman JM.  Intrauterine transfusion . In: Anderson KC, Ness PM, eds. Scientific Basis of Transfusion Medicine: Implications for Clinical Practice . Philadelphia, Pa: WB Saunders Co; 1994;; 4:403-420.
Judd WJ, Luban NLC, Ness PM, et al.  Prenatal and perinatal immunohematology: recommendations for serologic management of the fetus, newborn infant, and obstetric patient . Transfusion . 1990;;30:175-183.
Chitkara U, Wilkins I, Lynch L, et al.  The role of sonography in assessing the severityof fetal anemia in Rh- and Kell-isoimmunized pregnancies . Obstet Gynecol . 1993;;71:393-398.
Queenan JT, Tomai TP, Ural SH, et al.  Deviation in amniotic fluid optic density of a wavelength of 450 nm in Rh-immunized pregnancies from 14to40weeks of gestation: a proposal for clinic management . Am J Obstet Gynecol . 1993;;168:1370-1376.
Fisk NC, Bennett P, Warwick RM, et al.  Clinical utility of fetal RhD typing in alloimmunized pregnancies by means of polymerase chain reaction or aminocytes or chorionic villi . Am J Obstet Gynecol . 1994;;171:50-54.
Rübo J, Albrecht K, Lasch P, et al.  High-dose intravenous immune globulin therapy for hyperbilirubinemia caused by Rh hemolytic disease . J Pediatr . 1992;;121:93-97.
Bowman JM.  Antenatal suppression of Rh alloimmunization . Clin Obstet Gynecol . 1991;;34:296-303.
Bussel JB.  Autoimmune thrombocytopenic purpura . Hematol Oncol Clin North Am . 1990;;4:179-191.
Waters AH.  Autoimmune thrombocytopenia: clinical aspects . Semin Hematol . 1992;;29:18-25.
Kiefel V, Freitag E, Kroll H, et al.  Platelet autoantibodies (IgG, IgM, IgA) against glycoproteins IIb/ IIIa and Ib/IX in patients with thrombocytopenia . Ann Hematol . 1996;;72:280-285.
George JN, Woolf SH, Raskob GE, et al.  Idiopathic thrombocytopenic purpura: a practical guideline developed by explicit methods for the American Society of Hematology . Blood . 1996;;88:3-40.
Schulman I.  Idiopathic (immune) thrombocytopenic purpura in children: pathogenesis and treatment . Pediatr Rev . 1983;;5:173-178.
Walker RW, Walker W.  Idiopathic thrombocytopenia: initial illness and long term follow-up . Arch Dis Child . 1984;;59:316-322.
Blanchette VS, Luke B, Andrew M, et al.  A prospective, randomized trial of high-dose intravenous immune globulin G therapy, oral prednisone therapy, and no therapy in childhood acute immune thrombocytopenic purpura . J Pediatr . 1993;;123:989-995.
Kaden BR, Rosse WF, Hauch TW.  Immune thrombocytopenia in lymphoproliferative diseases . Blood . 1979;;53:545-551.
den Ottolander GJ, Gratama JW, de Koning J, Brand A.  Long-term follow-up study of 168 patients with immune thrombocytopenia: implications for therapy . Scand J Haematol . 1984;;32:101-110.
Pizzuto J, Ambriz R.  Therapeutic experience on 934 adults with idiopathic thrombocytopenic purpura: multicentric trial of cooperative Latin American Group on Hemostasis and Thrombosis . Blood . 1984;;64:1179-1183.
Law C, Marcaccio M, Tam P, et al.  High-dose intravenous immune globulin and the response to splenectomy in patients with idiopathic thrombocytopenic purpura . N Engl J Med . 1997;;336:1494-1498.
Bussel JB, Girariano JN, Kimberly RP, et al.  IV anti-D treatment of immune thrombocytopenic purpura: analysis of efficacy, toxicity, and mechanism of effect . Blood . 1991;;77:1984-1893.
Oksenhendler E, Seligmann M.  HIV-related thrombocytopenia . Immunodefic Rev . 1990;;2:221-231.
Gonzalez-Conejero R, Rivera J, Rosillo MC, et al.  Association of autoantibodies against platelet glycoproteins Ib/IX and IIb/IIIa, and platelet-reactive anti-HIV antibodies in thrombocytopenic narcotic addicts . Br J Haematol . 1996;;93:464-471.
Karpatkin S, Nardi MA, Hymes KB.  Sequestration of antiplatelet GpIIIa antibody in rheumatoid factor immune complexes of human immunodeficiency virus 1 thrombocytopenic patients . Proc Nati Acad Sci U S A . 1995;;92:2263-2267.
Kouri YH, Borkowsky W, Nardi M, et al.  Human megakaryocytes have a CD4 molecule capable of binding human immunodeficiency virus-1 . Blood . 1993;;81:2664-2670.
Hoxie JA.  Hematologic manifestations of AIDS . In: Hoffman R, Bunz EJ, Shattil SJ, et al, eds. Hematology: Basic Principles and Practice . New York, NY: Churchill-Livingstone; 1995;:2171-2200.
Chong BH, Du X, Berndt MC, et al.  Characterization of the binding domains on platelet glycoproteins Ib-IX and IIb/IIIa complexes for the quinine/ quinidine-dependent antibodies . Blood . 1991;;77:2190-2199.
Hackett T, Kelton JG, Powers P.  Drug-induced platelet destruction . Semin Thromb Hemost . 1982;;8:116-137.
Warkentin TE, Kelton JG.  Heparin-inducedthrombocytopenia . Prog Hemost Thromb . 1991;;10:1-34.
Warkentin TE, Kelton JG.  Interaction of heparin with platelets, including heparin-induced thrombocytopenia . In: Bounameaux H, ed. Low-Molecular Weight Heparins in Prophylaxis and Therapy of Thromboembolic Diseases . New York, NY: Marcel Dekker; 1994;:75.
Kelton JG, Smith JW, Warkentin TE, et al.  Immunoglobulin G from patients with heparin-induced thrombocytopenia binds to a complex of heparin and platelet factor 4 . Blood . 1994;;83:3232-3239.
Warkentin TE, Hayward CPM, Boshkov LK, et al.  Sera from patients with heparin-induced thrombocytopenia generate platelet-derived microparticles with procoagulant activity: an explanation for the thrombotic complications of heparin-induced thrombocytopenia . Blood . 1994;;84:3691-3699.
Bussel JB, Zabusky MR, Berkowitz RL, et al.  Fetal alloimmune thrombocytopenia . N Engl J Med . 1997;;337:22-26.
Newman PJ, Derbes RS, Aster RH.  The human platelet alloantigens PlA1 and PlA2, are associated with a leucine33/proline33 amino acid polymorphism in membrane glycoprotein IIIA, and are distinguishable by DNA typing . J Clin Invest . 1989;;83:1778-1781.
Suarez CR, Anderson C.  High-dose intravenous gammaglobulin (IVG) in neonatal immune thrombocytopenia . Am J Hematol . 1987;;26:247-253.
McFarland JG, Aster RH, Bussel JB, et al.  Prenatal diagnosis of neonatal alloimmune thrombocytopenia using allele-specific oligonucleotide probes . Blood . 1991;;78:2276-2282.
Bussel JB, Berkowitz RL, Lynch L, et al.  Antenatal management of alloimmune thrombocytopenia with intravenous gamma-globulin: a randomized trial of the addition of low-dose steroid to intravenous gamma-globulin . Am J Obstet Gynecol . 1996;;174:1414-1423.
Bux J, Mueller-Eckhardt C.  Autoimmune neutropenia . Semin Hematol . 1992;;29:45-53.
Sasama K.  Reports of 355 transfusion-associated deaths: 1976 through 1985 . Transfusion . 1990;;30:583-590.
Linden JV, Paul B, Dressler KP.  A report of 104 transfusion errors in New York State . Transfusion . 1992;;32:601-606.
Capon SM, Goldfinger D.  Acute hemolytic transfusion reaction, a paradigm of two systemic inflammatory responses: new insights into pathophysiology and treatment . Transfusion . 1995;;35:513-520.
Davenport RD, Strieler RM, Kunkel SL.  Red cell ABO incompatibility and production of tumor necrosis factor-alpha . Br J Haematol . 1991;;78:540-544.
Butler J, Parker D, Pillai R, et al.  Systemic release of neutrophil elastase and tumor necrosis factor alpha following ABO incompatible blood transfusion . Br J Haematol . 1991;;79:525-526.
Pineda AA, Tuswell HF, Brzic SM Jr.  Delayed hemolytic transfusion reaction: an immunologic hazard of blood transfusion . Transfusion . 1978;;18:1-7.
Kevy SV, Schmidt PJ, McGinnis MH, et al.  Febrile, nonhemolytic transfusion reactions and the limited role of leukoagglutinins in their etiology . Transfusion . 1962;;2:7-16.
Heddle NM, Klama LN, Griffin L, et al.  A prospective study to identify risk factors associated transfusion reactions with acute reactions to platelet and red cell transfusions . Transfusion . 1993;;33:794-797.
Dzik W.  Is the febrile response to transfusion due to donor or recipient cytokine? Transfusion . 1992;;32:594.
Muylle L, Joos M, Wourters E, et al.  Increased tumor necrosis factor alpha, interleukin-1, and interleukin-6 levels in plasma of stored platelet concentrates: relationship between TNF alpha and IL-6 levels and febrile transfusion reactions . Transfusion . 1993;;33:195-199.
Heddle NM, Klama LN, Singer J, et al.  The role of plasma from platelet concentrates in transfusion reactions . N Engl J Med . 1994;;331:625-628.
Aye MT, Palmer DS, Giulivi A, et al.  Effect of filtration of platelet concentrates on the accumulation of cytokines and platelet release factors during storage . Transfusion . 1995;;35:117-124.
Stephen CR, Martin RC, Bourgeois-Gavardin M.  Antihistaminic drugs in treatment of nonhemolytic transfusion reactions . JAMA . 1955;;152:525-529.
Sandler SG, Mallory D, Alamut, et al.  IgA anaphylactic transfusion reactions . Transfus Med Rev . 1995;;9:1-8.
Bjerrum OJ, Jersild C.  Class-specificanti-IgA associated with severe anaphylactic transfusion reactions in a patient with pernicious anemia . Vox Sang . 1971;;21:411-424.
Popovsky MA, Moore SB.  Diagnostic and pathogenic considerations in transfusion- related acute lung injury . Transfusion . 1985;;25:573-577.
Popovsky MA, Chaplin HC, Moore SB.  Transfusion-related acute lung injury: a neglected, serious complication of hemotherapy . Transfusion . 1992;;32:589-592.
Anderson KC, Weinstein HJ.  Transfusion-associated graft-versus-host disease . N Engl J Med . 1989;;323:15-21.
Thaler M, Shamuss A, Aorgad S, et al.  The role of blood from HLA-homozygous donors in fatal transfusion-associated graft-versus-host disease after open heart surgery . N Engl J Med . 1989;;321:25-28.
Klein HG, ed. Standards for Blood Banks and Transfusion Services . 17th ed. Bethesda, Md: American Association of Blood Banks; 1996;.
Przepiorka D, LePark GF, Stovall MA, et al.  Use of irradiated blood components: practice parameter . Am J Clin Pathol . 1996;;106:6-11.
Mueller-Eckhardt C, Keefel V.  High dose IgG for post-transfusion purpura-revisited . Br J Haematol . 1988;;57:163-167.
Ehrenfort S, Kreuz W, Scharrer I, et al.  Incidence of development of factor VIII and factor IX inhibitors in hemophiliacs . Lancet . 1992;;339:594-598.
Robert SHR, Sallah S.  Immunology of inhibitors to clotting factors with emphasis on FVIII . In: Silberstein LE, ed. Autoimmune Disorders of Blood . Bethesda, Md: American Association of Blood Banks; 1996;:151-170.
Brettler DB, Forseberg AD, Levine PH, et al.  The use of porcine factor VIII concentrates (Hyate: C) in the treatment of patients with inhibitor antibodies to FVIII: multicenter US experience . Arch Intern Med . 1989;;149:1381-1385.
Sultan Y, Maisonneuve P, Kazatchkine MD, Nydegger UE.  Anti-idiotypic suppression of autoantibodies to factor VIII (anti-haemophilic factor) by high-dose intravenous gammaglobulin . Lancet . 1984;;2:765-768.
Permpikul P, Rao LV, Rapaport SI.  Functional and binding studies of the roles of prothrombin and β2-glycoprotein I in the expression of lupus anticoagulant activity . Blood . 1994;;83:2878-2892.
Canoso RT, de Oliveira RM.  Chlorpromazine-induced lupus anticoagulant anticardiolipin antibodies and lupus anticoagulant: absence of thrombosis . Am J Hematol . 1988;;27:272-275.
Schleider MA, Nachman RL, Jaffe EA, et al.  A clinical study of the lupus anticoagulant . Blood . 1976;;48:499-509.
Love PE, Santoro SA.  Antiphospholipid antibodies: anticardiolipin and the lupus anticoagulant in systemic lupus erythematosus (SLE) and in non-SLE disorders . Ann Intern Med . 1990;;112:682-698.
Lechner K, Pabinger-Fasching I.  Lupus anticoagulant and thrombosis: a study of 25 cases and review of the literature . Hemostasis . 1985;;15:254-262.
Asherson RA, Khamashta MA, Gill A, et al.  Cerebrovascular disease and antiphospholipid antibodies in systemic lupus erthematosus, lupus-like disease, and the primary antiphospholipid syndrome . Am J Med . 1989;;86:391-399.
Galli M, Finazzi G, Barbui T.  Thrombocytopenia in the antiphospholipid syndrome . Br J Haematol . 1996;;93:1-5.
Harris EN, Asherson RA, Hughes GRV.  Antiphospholipid antibodies: autoantibodies with a difference . Annu Rev Med . 1988;;39:261-271.
Triplett DA, Brandt JT, Musgrave KA, Orr CA.  The relationship between lupus anticoagulants and antibodies to phospholipid . JAMA . 1988;;259:550-554.
Cowchock S.  Autoantibodies and pregnancy loss . N Engl J Med . 1997;;337:197-198.
Laskin CA, Bombardier C, Hannah ME, et al.  Prednisone and aspirin in women with autoantibodies and unexplained recurrent fetal loss . N Engl J Med . 1997;;337:148-153.
Rosove MH, Tabsh K, Wasserstrum N, et al.  Heparin therapy for pregnant women with lupus anticoagulants or anticardiolipin antibodies . Obstet Gynecol . 1990;;75:630-634.
Mangan KF, Chikkappa G, Farley PC.  T gamma cells suppress growth of erythroid colony-forming units in vitro in the pure red cell aplasia of B-cell chronic lymphocytic leukemia . J Clin Invest . 1982;;70:1148-1156.
Chapel H, Bunch C.  Mechanisms of infections in chronic lymphocytic leukemia . Semin Hematol . 1987;;24:291-296.
Kurec AS, Threatte GA, Gottlieb AJ, et al.  Immunophenotypic subclassification of chronic lymphocytic leukemia (CLL) . Br J Haematol . 1992;;81:45-51.
Kay NE.  Abnormal T-cell subpopulation function in CLL: excessive suppressor (T) and deficient helper (T) activity with respect to B-cell proliferation . Blood . 1981;;57:418-420.
Vartersian ML.  Biologic and clinical advances in multiple myeloma . Oncology . 1995;;9:417-424.
Kyle RA, Greipp PR.  The laboratory investigation of monoclonal gammopathies . Mayo Clin Proc . 1978;;53:719-739.
Klein B, Zhang XG, Lu ZY, et al.  Interleukin-6 in human multiple myeloma . Blood . 1995;;85:863-873.
Kyle RA, Lust JA.  Monoclonal gammopathies of undetermined significance . Semin Hematol . 1989;;26:176-200.
Crawford J, Cox EB, Cohen JH.  Evaluation of hyperviscosity in monoclonal gammopathies . Am J Med . 1985;;79:13-22.
Kantarjian HM, Redman JR, Keating MJ.  Fludarabine phosphate therapy in other lymphoid malignancies . Semin Oncol . 1990;;17( (suppl 8) ):66-70.
Gertz MA, Li C-Y, Shirahama T, Kyle RA.  Utility of subcutaneous fat aspiration for the diagnosis of systemic amyloidosis (immunoglobin light chain) . Arch Intern Med . 1988;;148:929-933.
Greipp PR, Kyle RA, Bowie EJW.  Factor-X deficiency in amylodosis: a critical review . Am J Hematol . 1981;;11:443-450.
Holmgren G, Ericzon BG, Groth CG, et al.  Clinical improvement and amyloid regression after liver transplantation in hereditary transthyretin amyloidosis . Lancet . 1993;;341:1113-1116.
Sipe J D.  Amyloidosis . Annu Rev Biochem . 1992;;61:947-975.
Levo Y, Gorevic PD, Kassab JH, et al.  Association between hepatitis B virus and essential mixed cryoglobulinemia . N Engl J Med . 1977;;296:1501-1504.
Pascual M, Perrin L, Giostra E,et al.  Hepatitis C virus in patients with cryoglobulinemia type II . J Infect Dis . 1990;;162:569-570.
Ferri C, Marzo E, Longombardo G, et al.  Interferon-α in mixed cryoglobulinemia patients: a randomized, crossover-controlled trial . Blood . 1993;;81:1132-1136.
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To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
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