Specificities and isotypes of erythrocytes autoantibodies in patients with warm autoimmune hemolytic anemia

Gilberto Soler Noda, Antonio Bencomo Hernández, Suharmi Aquino Rojas, Yisenia Romero Díaz

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Introduction: Autoimmune hemolytic anemia is a rare disorder characterized by hemolysis mediated by autoantibodies directed against red blood cells. The demonstration of antibody specificity is a very difficult procedure since autoantibodies in general are nonspecific of antigens and react with all erythrocytes analyzed. Occasionally, specificity is observed against the Rh system antigens.

Objective: To determinate the specificity of erythrocytes autoantibodies in DAT positive autoimmune hemolytic anemia by MAIEA technique.

Methods: The specificity and isotype of erythrocyte autoantibodies were determined in the eluate of 109 blood samples from patients with warm autoimmune hemolytic anemia, by means of the MAIEA technique and the use of monoclonal antibodies that recognized 11 blood group systems and the protein CD47.

Results: In 100% of cases autoantibodies against Rh system antigens were detected; in 24 cases we detected autoantibodies of IgA and IgM isotypes that recognized different antigens that were recognized by IgG isotype autoantibodies. For idiopathic and secondary warm autoimmune hemolytic anemias, predominance was observed against three or more specificities. IgG was detected in 99.09% of the eluates, IgA in 35.77% and IgM in 16.51%. The high degree of hemolysis was related to the presence of several isotype autoantibodies against four or more blood group specificities.

Conclusions: The MAIEA technique is a sensitive method that can be used to determine the specificities and isotypes of autoantibodies in patients with warm autoimmune hemolytic anemia.

Palabras clave

autoimmune hemolytic anemia; AIHA; warm autoimmune hemolytic anemia; WAIHA; monoclonal antibody-specific immobilization of erythrocyte antigens assay; MAIEA; erythrocytes autoantibodies; specificities of autoantibodies; isotypes of autoantibodies

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