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首页> 外文期刊>Journal of clinical laboratory analysis. >Defining the clinical relevance of red blood cell autoantibodies by Monocyte Monolayer Assay
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Defining the clinical relevance of red blood cell autoantibodies by Monocyte Monolayer Assay

机译:单核细胞单层测定定义红细胞自身抗体的临床相关性

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Background The Monocyte Monolayer Assay ( MMA ) is an in vitro simulation of red blood cell ( RBC ) alloantibody behavior. It has been classically applied to predict the risks of post‐transfusion hemolytic reactions when transfusing incompatible RBC units. Quantifying erythrophagocytosis by MMA may be an interesting option for situations where there is doubt whether a RBC autoantibody is mediating significant hemolysis. Here, we present three situations involving RBC autoantibodies in which the MMA was decisive for clarifying the diagnosis and choosing the best clinical treatment. Case Report Case 1 . Pregnant patient with severely anemic fetus exhibited warm autoantibody without signs of hemolysis. MMA revealed 30% of monocyte index ( MI ) highlighting that fetal hemolysis was caused by maternal autoantibody. Prednisone was prescribed with fetal clinical improvement. Cases 2 and 3 . Two patients with the diagnosis of mixed auto‐immune hemolytic anemia and poor response to corticosteroids were evaluated using MMA . The resulting MI was less than 10% in both cases, suggesting that the cold‐agglutinin rather than the warm auto‐IgG was responsible for overt hemolysis. Treatment with rituximab was begun, with good clinical response. Conclusion MMA can be used to evaluate the ability of RBC autoantibodies to mediate overt hemolysis. It can be especially useful to determine the role played by cold and warm auto‐antibodies in mixed auto‐immune hemolytic disease, helping to define the best treatment option.
机译:背景技术单核细胞单层测定(MMA)是红细胞(RBC)Alloantibody行为的体外模拟。它经典申请预测转发后输血后溶血反应的风险,当转发不相容的RBC单元时。 MMA量化红细胞增多率可能是有趣的情境,其中疑问RBC自身抗体是否正在介导大量溶血。在这里,我们提出了三种情况,涉及RBC自身抗体,其中MMA是对澄清诊断和选择最佳临床治疗的决定性。案例报告案例1。患有严重贫血胎儿的怀孕患者在没有溶血的情况下呈现温暖的自身抗体。 MMA揭示了30%的单核细胞指数(MI)突出显示胎儿溶血是由母体自身抗体引起的。泼尼松以胎儿临床改进规定。案例2和3。使用MMA评估两名患有混合自身免疫溶血性贫血和对皮质类固醇差的患者的患者。两种情况下,所得Mi小于10%,表明冷 - 凝集素而不是温暖的Auto-IgG负责公开的溶血。初步临床反应,用蓖麻毒素治疗。结论MMA可用于评估RBC Auto istibodies介导公开溶血的能力。确定在混合自身免疫溶血性疾病中的寒冷和温暖的自动抗体中发挥作用的作用,有助于确定最佳治疗选择。

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