engleski

Study of 188 DAT-positive patients, part I: serologic features

Materials and methods:188 DAT-positive patients (DATs) >6 months (hemolytic/serologic reactions excluded) analyzed by DAT Screening I, DiaPanels and DiaCidel(Diamed).Results: DATs were 52.6 (0.5–95) years, 57% female, 59% found at blood grouping/cross reactions, only 15% at AIHA investigation, coming from internal medicine (58%, hematology 28%), hemodialysis (11%) and ‘‘unusual dpts’’ (18%), with often diagnosis: primary AIHA (16%), lymphoproliferations (13%), renal insufficiency (9%), solid tumors (8%) and cyrrhosis (5%). In 153 IgG DATs, 77 warm autoAbs and 76 negative eluates were found. In 28 IgG + C3d DATs 17 were warm, three warm/cold AIHA and eight due to drug or immune complexes (IC). In seven C3d DATs, four were cold AIHA and three due to drugs/IC. Antibody screening was positive in 109 (58%) DATs: 28%polyspecific, 10% specific autoAbs (anti-e, e + C, E, E + c, c, N and I), 39% polyspecificauto + allo and 11% alloAbs were found. Anti-E was found in 22, K in 15, c in eight, C in seven, D and HLA in five, Jka in four, S and Lua in two, Jkb, Fya, Fyb, Cw, M, Kn1and Ch1 in one patient. 14 patients had >1 alloAb. Three eluted anti-E, one E + c andone K alloAb pointed to five possible HTRs. In w, 1+ or 2+ DATs elution was more often negative (67%) than in 3+/4+ DATs (11%).Conclusions: DATs are common over 50, but few patient groups may be prone to routine DAT. DATs and alloimmunisation seem connected: either autoimmune conditions make patients prone to alloimmunisation or immunomodulation caused by alloimmunisation leads to autoimmune events.

188 DAT-positive patients, serologic features

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