Immunohematology最新文献

{"title":"Cephalosporin-induced hemolytic anemia: a case study.","authors":"Graça Almeida, Ana Costa, Eugénia Vasconcelos","doi":"10.2478/immunohematology-2025-016","DOIUrl":"10.2478/immunohematology-2025-016","url":null,"abstract":"<p><p>Drug-induced immune hemolytic anemia (DIIHA) represents a rare but dangerous medical condition that more often affects children who are administered cephalosporins. A 10-year-old girl developed severe hemolysis after administration of cefuroxime and ceftriaxone for treating an infection linked to parotid lymphangioma. The patient had previously tolerated ceftriaxone and clindamycin but developed dizziness, pallor, and tachycardia, and her hemoglobin (Hb) levels decreased from 12.9 to 2.6 g/dL during her fourth day of treatment, which led to hypovolemic shock and transient renal dysfunction. Our objective is to establish cefuroxime and ceftriaxone as the responsible drugs for DIIHA through immunohematologic testing. The laboratory tests included the direct antiglobulin test (DAT) and the indirect antiglobulin test (IAT) along with drug-dependent antibody testing using the patient's serum (1) to react against group O red blood cells (RBCs) treated with cefuroxime and (2) to react separately against group O RBCs not treated with, but in the presence of, ceftriaxone, with and without complement, at both room temperature and by the IAT. The DAT showed positivity for IgG and C3d. The patient's serum reacted with cefuroxime-treated RBCs by the IAT and reacted with untreated RBCs when ceftriaxone and complement were present. The laboratory results showed that drug-dependent antibodies were present to target RBCs. The patient's condition improved rapidly after stopping cephalosporins and starting ciprofloxacin/levofloxacin and clindamycin, which resulted in an Hb increase to 9.1 g/dL within 48 hours and the absence of hemoglobinuria. This case shows why health care professionals must identify DIIHA early through diagnostic testing even when patients have shown previous tolerance to antibiotics. This case report also shows that both cefuroxime and ceftriaxone were the drugs responsible for the DIIHA.</p>","PeriodicalId":13357,"journal":{"name":"Immunohematology","volume":"41 4","pages":"111-116"},"PeriodicalIF":0.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145933237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and characteristics of irregular antibodies in northern Vietnamese blood donors.","authors":"Tung Nguyen, Nga Hoang, Dung Nguyen, Thanh Nguyen","doi":"10.2478/immunohematology-2025-013","DOIUrl":"10.2478/immunohematology-2025-013","url":null,"abstract":"<p><p>Irregular antibodies with the potential for causing transfusion reactions can be detected in healthy donors. The prevalence and characteristics of irregular antibodies in many populations are well known; however, the data of Vietnamese blood donors have not yet been reported. Our study was performed to assess the frequency and specificities of irregular antibodies among healthy blood donors in the north of Vietnam. A total of 199,281 blood donor samples were screened for irregular antibodies from 2021 to 2023. Antibody screening was performed by both microplate and tube methods. Positive tests were further confirmed using a gel card method. Subsequently, antibody identification was performed. The occurrence of a positive antibody detection test was 0.37 percent. Most cases had only one antibody (99.1%); the proportion of donors who had two and three antibodies accounted for 0.8 and 0.1 percent, respectively. The most frequently identified antibodies were of the MNS blood group system, with anti-Mi^a being the highest (72.7%) and then anti-M (12.9%), followed by the Lewis blood group system with anti-Le^a (6.5%) and anti-Leb (2.4%). The results show the rate and characteristics of irregular antibodies in northern Vietnamese blood donors. These findings provide essential data to support recommendations for implementing antibody detection in donor testing nationwide. Moreover, the results underscore the importance of selecting appropriate reagent panels.</p>","PeriodicalId":13357,"journal":{"name":"Immunohematology","volume":"41 3","pages":"84-89"},"PeriodicalIF":0.0,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145408906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kell and Kx blood group systems: an update.","authors":"Candice L Davison, Gregory A Denomme","doi":"10.2478/immunohematology-2025-014","DOIUrl":"https://doi.org/10.2478/immunohematology-2025-014","url":null,"abstract":"<p><p>This review updates knowledge on the Kell (International Society of Blood Transfusion [ISBT] 006) and Kx (ISBT 019) blood group systems since the last review published in <i>Immunohematology</i> in 2015. It highlights new insights into the relationship between Kell glycoprotein and red blood cell (RBC) membrane stability, including recent discoveries of new antigens and alleles, and reporting of the first diagnosis of McLeod syndrome in an infant. The Kell and Kx blood group systems welcome an increasing number of antigens and/or alleles to their systems. Kell has a total of 38 antigens as of January 2025; a further 25 novel alleles encode K_mod phenotypes, and an additional 71 nucleotide changes are associated with the K₀ (null) phenotype. XK follows a similar theme with an ever-increasing number of new alleles, all encoding the Kx- (null) phenotype. The review emphasizes the role of molecular diagnostics in resolving serologic ambiguities in the blood bank or assisting the diagnosis of neurodegenerative syndromes. The monitoring and management of anti-K in pregnancy is evolving. Emerging technologies such as single-cell sequencing and multi-omics analysis workflows, gene editing, and cellular therapeutics may unlock the inner workings of Kell and Kx protein mechanics and elucidate the function of Kell protein biology, structural immunogenicity, and explain why alloanti-K is capable of suppressing erythroid growth.</p>","PeriodicalId":13357,"journal":{"name":"Immunohematology","volume":"41 3","pages":"90-99"},"PeriodicalIF":0.0,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145408891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of 0.8 percent reagent red blood cell panels after extended on-board analyzer utilization.","authors":"Tina Jacobucci, Kelly Bizovie, Darlene Mueller","doi":"10.2478/immunohematology-2025-011","DOIUrl":"https://doi.org/10.2478/immunohematology-2025-011","url":null,"abstract":"<p><p>Automated pre-transfusion testing provides significant improvements in efficiency and productivity along with a reduction of the potential for errors. With reflex test capability and bidirectional Laboratory Information System interfacing, enhanced levels of effectiveness can be achieved in delivery of test results. To improve efficiency and productivity in our laboratory related to antibody identification (AbID) on our automated testing analyzer, we conducted a study that would allow for extended on-board utilization of our AbID reagent red blood cells (RRBCs). Our current process requires loading the 0.8 percent AbID RRBC panel onto the analyzer at the time of antibody detection and then removing and returning it to refrigerated storage once the AbID test has been completed. Our study was conducted at two hospital sites with an initial pilot study to determine the feasibility of using the RRBC panel on board with evaporation caps over a 7-day timeframe upon initial use of the panel and at two different timeframes later in the panel shelf life. Once the initial pilot study was completed and the feasibility of use established, a secondary study was initiated to determine if stability of reactivity was maintained using a rotational approach of time on board the analyzer compared with time in standard refrigerated storage. A 12-hour rotation at hospital 1 over a 2-week period and a 24-hour rotation at hospital 2 over a 3-week period were evaluated. Anti-c and anti-Fy^a were used at one site while the other site used anti-E and anti-K. Respective negative controls were tested at both sites. Results of the pilot study demonstrated that the reactivity of the antibodies tested over the 7-day timeframe was maintained along with antibody specificity. The secondary study demonstrated sustained reactivity strength when using the rotational approach but showed occasional yet inconsistent results with respect to specific RRBC deterioration, fibrin in patient's plasma, or indeterminate occurrence. Based on the results of the study, a 7-day on-board utilization protocol was established for routine use. The new extended on-board protocol offers enhanced performance, efficiency, and safety for our transfusion medicine operations.</p>","PeriodicalId":13357,"journal":{"name":"Immunohematology","volume":"41 3","pages":"73-79"},"PeriodicalIF":0.0,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145408853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Loss of D expression associated with hematologic disease progression: a case report and review of the literature.","authors":"Nalan Yurtsever, Gabrielle Carmichael, Peining Li, Jia Di Wen, Hongyan Chai, Autumn Diadamo, Gregory Denomme, Christopher Tormey","doi":"10.2478/immunohematology-2025-012","DOIUrl":"10.2478/immunohematology-2025-012","url":null,"abstract":"<p><p>We report a case of a 61-year-old male patient with a complex hematologic history including pre-B acute lymphocytic leukemia, allogeneic stem cell transplant, and newly treated colon cancer followed by diagnosis of high-risk myelodysplastic syndrome (MDS), who exhibited abolishment of D antigen production. The patient's red blood cells (RBCs), which originally typed as group A, D+, again typed as group A, D+, after receiving stem cells from a female donor with the same blood type. The reactivity of the patient's RBCs was strong when tested with anti-D reagent until he was treated for colon cancer. Within 6 months of diagnosis of cancer, he developed a mixed-field D typing result followed by a complete D- phenotype over the course of a few weeks, coinciding with the new diagnosis of MDS and initiation of immunosuppressive therapy. Polymerase chain reaction (PCR) testing revealed no weak or partial D variants, and subsequent Sanger sequencing confirmed the presence of a conventional <i>RHD</i> gene. A more focused analysis by chromosomal microarray identified deletions involving the <i>RHD</i> locus, supporting the hypothesis that active MDS disrupted gene expression. The patient received another stem cell transplant, this time from a group AB, D+ male donor. In a short period of time, MDS re-emerged along with re-identification of microarray mutations encompassing <i>RHD</i> in female cells (from the first donor) even after the second stem cell transplant. However, D expression remained strong, underscoring the presence of enough male donor <i>RHD</i> expression to maintain the D+ phenotype.</p>","PeriodicalId":13357,"journal":{"name":"Immunohematology","volume":"41 3","pages":"80-83"},"PeriodicalIF":0.0,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145408918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of unexplained reactivity: antibody of unknown specificity (AUS).","authors":"Janis R Hamilton, Christine Lomas-Francis, Sandra J Nance","doi":"10.2478/immunohematology-2025-008","DOIUrl":"https://doi.org/10.2478/immunohematology-2025-008","url":null,"abstract":"<p><p>When antibody screening results are positive in a patient\"s sample, the next step is to identify the specificity of the antibody and plan for transfusion or treatment needs. Most often, the antibody can be identified at the transfusing facility; samples that are not resolved may be referred to an immunohematology reference laboratory. A portion of these referred samples may still not be resolved, and the antibodies in these cases have been termed \"antibodies of unidentified or undetermined specificity\". In this publication, we selected the term \"unknown\" for such antibodies. Local medical staff should be involved in the clinical management and transfusion recommendations for these patients. The flow charts described in this article are designed to guide the serologist through steps that may result in a defined antibody specificity, or they may not resolve the specificity, and thus, the antibody remains an \"antibody of unknown specificity\".</p>","PeriodicalId":13357,"journal":{"name":"Immunohematology","volume":"41 2","pages":"49-53"},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Rh blood group system: RHD update.","authors":"Glenn Ramsey","doi":"10.2478/immunohematology-2025-007","DOIUrl":"https://doi.org/10.2478/immunohematology-2025-007","url":null,"abstract":"<p><p>The Rh blood group system was last reviewed in <i>Immunohematology</i> in 2010 (Chou ST, Westhoff CM. The Rh and RhAG blood group systems. Immunohematology 2010;26:178-86). This update focuses on RHD, RhD structure, alterations in D expression, anti-D alloimmunization, and applications of RHD genotyping for weak and discrepant D phenotypes; identification of RHD genotypes that encode partial D phenotypes; and prevention and management of anti-D in pregnancy. Updates to the RHAG system and to RHCE and its encoded antigens are in recent or upcoming publications of <i>Immunohematology</i>, respectively.</p>","PeriodicalId":13357,"journal":{"name":"Immunohematology","volume":"41 2","pages":"31-48"},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The utility of an acid elution when a direct antiglobulin test is positive due to complement alone.","authors":"Beth M Meyer","doi":"10.2478/immunohematology-2025-009","DOIUrl":"https://doi.org/10.2478/immunohematology-2025-009","url":null,"abstract":"<p><p>Acid elutions are intended to recover IgG antibodies from the red blood cell (RBC) surface. Eluates from samples that are direct antiglobulin test (DAT) positive with complement (C3) only would be expected to be negative. However, elution studies performed on RBCs that are DAT positive with C3 only can produce clinically significant results. Identifying how often clinically relevant information is obtained when elutions are performed on samples DAT positive with C3 alone would aid in developing guidelines for elution performance on these samples and reducing performance of eluates on such samples with clinically insignificant results. Patient samples that are DAT positive with C3 only submitted over an 11.5-month period at the American Red Cross' Immunohematology Reference Laboratory locations were identified. The eluate result, serum result, transfusion history, and patient diagnosis were captured and analyzed. In total, 1171 samples that were DAT positive with C3 only were identified and, of those, 321 (27%) samples had an elution performed. A nonreactive eluate was the most common result. Alloantibodies were identified in 19 (6%) eluates. Panagglutination/autoantibodies was identified in 71 (22%) eluates. Informative eluates were identified as those eluates showing any alloantibody, regardless of serum results, or panagglutination/autoantibody present in the eluate but not concurrently present in the serum (n = 30,9%). Guidelines based on recent transfusion history, indicators of active hemolysis, and autoimmune reactivity concurrently in the serum should be implemented to identify clinically significant information and to reduce the number of uninformative elutions performed.</p>","PeriodicalId":13357,"journal":{"name":"Immunohematology","volume":"41 2","pages":"54-60"},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and clinical implications of unexpected red blood cell antibodies in a tertiary care hospital in Sri Lanka.","authors":"Trileeshiya I Withanawasam, Nashma Sainudeen","doi":"10.2478/immunohematology-2025-003","DOIUrl":"10.2478/immunohematology-2025-003","url":null,"abstract":"<p><p>Unexpected red blood cell (RBC) alloantibodies can lead to hemolytic transfusion reactions and hemolytic disease of the fetus and newborn (HDFN). Screening for these antibodies is essential to ensure transfusion safety and improve patient care. Prevalence and frequency of unexpected antibodies vary among populations, influenced by genetic and demographic factors. This study addresses the gap in data specific to University Hospital, General Sir John Kotelawala Defence University. A retrospective analysis was performed on 20,212 patients (40.74% pregnant women and 59.25% transfusion recipients) from November 2019 to August 2024, assessing the prevalence, distribution, and clinical relevance of RBC alloantibodies. The study found that 0.80 percent of patients were alloimmunized and 28.87 percent of the antibodies were clinically significant. Common antibodies included anti-Le^b (27.27%) and anti-Lea (19.25%); anti-D was the most frequent among Rh antibodies. A significantly higher proportion of pregnant women were alloimmunized compared with transfusion recipients (<i>p</i> < 0.000). Among D- pregnant women, 5.45 percent were alloimmunized, mainly with anti-D. HDFN was identified with either maternal anti-D or anti-E. These findings emphasize the need for early antibody detection and monitoring to enhance transfusion safety, suggesting policy improvements for antibody screening in transfusion and antenatal care in Sri Lanka.</p>","PeriodicalId":13357,"journal":{"name":"Immunohematology","volume":"41 1","pages":"4-10"},"PeriodicalIF":0.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contents.","authors":"","doi":"10.2478/immunohematology-2025-001","DOIUrl":"https://doi.org/10.2478/immunohematology-2025-001","url":null,"abstract":"","PeriodicalId":13357,"journal":{"name":"Immunohematology","volume":"41 1","pages":"i-ii"},"PeriodicalIF":0.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143718537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}