{"title":"Anti-IH in myelodysplastic syndrome","authors":"Ketsaraporn Wongba , Pornlada Nuchnoi , Chotiros Plabplueng , Charuporn Promwong","doi":"10.1016/j.plabm.2025.e00468","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Anti-IH exhibits complex specificity, strongly reacting with cells expressing both H and I antigens at cold temperatures. Its clinical significance has been increasingly recognized, particularly in patients with hematologic conditions such as myelodysplastic syndrome (MDS) and chronic myelomonocytic leukemia (CMML).</div></div><div><h3>Case report</h3><div>We present an 83-year-old Thai female with MDS who was transfusion-dependent. She presented with severe anemia requiring an urgent transfusion. The patient was group A RhD-positive. Antibody screening and identification using column agglutination technology (CAT) showed weak polyagglutination. Auto-control and direct antiglobulin tests (DAT) were negative. Red cell typing showed absence of H antigen and presence of A1 antigen. Further testing with cord O cells revealed no agglutination, confirming the A1 blood group with anti-IH. Antibody screening and identification studies showed cold-reactivity, with weak reactivity at 37 °C and in the AHG phase. Crossmatching with two group A leukocyte-poor red cells was compatible, and transfusion was uneventful.</div></div><div><h3>Conclusion</h3><div>This is the first reported case of anti-IH in a Thai patient. Anti-IH may complicate pre-transfusion testing and mask alloantibodies, necessitating careful interpretation and confirmatory testing to prevent transfusion-related complications.</div></div>","PeriodicalId":20421,"journal":{"name":"Practical Laboratory Medicine","volume":"45 ","pages":"Article e00468"},"PeriodicalIF":1.7000,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Practical Laboratory Medicine","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2352551725000216","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICAL LABORATORY TECHNOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background
Anti-IH exhibits complex specificity, strongly reacting with cells expressing both H and I antigens at cold temperatures. Its clinical significance has been increasingly recognized, particularly in patients with hematologic conditions such as myelodysplastic syndrome (MDS) and chronic myelomonocytic leukemia (CMML).
Case report
We present an 83-year-old Thai female with MDS who was transfusion-dependent. She presented with severe anemia requiring an urgent transfusion. The patient was group A RhD-positive. Antibody screening and identification using column agglutination technology (CAT) showed weak polyagglutination. Auto-control and direct antiglobulin tests (DAT) were negative. Red cell typing showed absence of H antigen and presence of A1 antigen. Further testing with cord O cells revealed no agglutination, confirming the A1 blood group with anti-IH. Antibody screening and identification studies showed cold-reactivity, with weak reactivity at 37 °C and in the AHG phase. Crossmatching with two group A leukocyte-poor red cells was compatible, and transfusion was uneventful.
Conclusion
This is the first reported case of anti-IH in a Thai patient. Anti-IH may complicate pre-transfusion testing and mask alloantibodies, necessitating careful interpretation and confirmatory testing to prevent transfusion-related complications.
期刊介绍:
Practical Laboratory Medicine is a high-quality, peer-reviewed, international open-access journal publishing original research, new methods and critical evaluations, case reports and short papers in the fields of clinical chemistry and laboratory medicine. The objective of the journal is to provide practical information of immediate relevance to workers in clinical laboratories. The primary scope of the journal covers clinical chemistry, hematology, molecular biology and genetics relevant to laboratory medicine, microbiology, immunology, therapeutic drug monitoring and toxicology, laboratory management and informatics. We welcome papers which describe critical evaluations of biomarkers and their role in the diagnosis and treatment of clinically significant disease, validation of commercial and in-house IVD methods, method comparisons, interference reports, the development of new reagents and reference materials, reference range studies and regulatory compliance reports. Manuscripts describing the development of new methods applicable to laboratory medicine (including point-of-care testing) are particularly encouraged, even if preliminary or small scale.