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Drug-induced immune hemolytic anemia (DIIHA) is a rare cytopenia caused by damage to RBCs by drug-induced antibodies or non-immune protein adsorption (NIPA). The drugs associated with DIIHA and the mechanistic hypotheses that are thought to be involved have been controversial, with complex serological tests often required by specialized Immune Hematology laboratories for diagnosis. It is necessary to know the clinical manifestation and laboratory diagnosis of DIIHA in order to distinguish the immuno-hematological abnormality caused by drugs from other causes. How to improve the diagnostic ability of DIIHA and establish a scientific and reasonable idea of DIIHA serological examination is urgent to help clinical diagnosis and correct treatment.
ABSTRACT
【Objective】 To strengthen the management of transfusion adverse events, so as to reduce the occurrence of medical damage and accidents, and guarantee the safety of blood transfusion. 【Methods】 The adverse events of blood transfusion reported in our hospital from July 2016 to December 2022 were collected, the reasons were tracked, and continuous improvements were made. 【Results】 From 2016 to 2022, a total of 315 transfusion adverse events were reported, including 233(73.97%, 233/315) cases of transfusion reactions and 82(26.03%, 82/315) transfusion adverse events. There were 271 328 transfusion cases in the same period, and the incidence of transfusion reactions was 0.858 7‰(233/271 328). The number of transfusion application was 129 887, and the incidence of transfusion adverse event is 0.631 3‰(82/129 887). Sixty-eigtht(82.93%, 68/82) cases of transfusion adverse events were caused by human factors, while the other 14(17.07%, 14/82) cases were non-human factors. According to the linear regression analysis, we have concluded that the year is a significant indicator for transfusion reaction rates (P0.05). 【Conclusion】 Strengthening the management of reporting adverse events in clinical blood transfusion, monitoring the incidence, analyzing and improving different types of adverse events by management tools can reduce the medical risks of blood transfusion and help to guarantee the safety of clinical blood transfusion.
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【Objective】 To investigate the profiles of RhC, c, E, and e antigens and phenotypes in 4 704 inpatients from multiple regions, i. e. Nanning, Guangzhou and Shenzhen, and provide data information for compatibility blood transfusion of Rh blood group. 【Methods】 The Rh blood group antigens were detected by microcolumn gel cards from three manufactures. If the test and the control results are inconsistent, a third-party reagent would be used, and traditional tube method for confirmation if needed. The Chi-square test and Fisher's exact test were used to analyze antigen frequency and Rh phenotypes in each region. 【Results】 Among the 4 704 inpatients, the frequency of C, c, E, and e antigen was e(91.77%)>C(85.64%)>c(49.62%)>E(41.60%), and Rh phenotypes distribution was CCee(49.40%)>CcEe(27.53%)>Ccee(8.16%)>ccEE(7.74%)>ccEe(4.89%)>CCEe(0.96%)>ccee(0.83%)>CcEE(0.47%)>CCEE(0.02%). There were significant differences in Rh blood type distribution among Nanning, Guangzhou and Shenzhen(P<0.05). Differences in Rh phenotype distribution between male and female were noticed in Shenzhen(P< 0.05), but not in Nanning or Guangzhou. 【Conclusion】 The distribution of Rh blood group in Shenzhen, Nanning and Guangzhou were significantly different from each other, therefore regional characteristics should be considered when carrying out Rh-compatible blood transfusion, so as to guarantee the security of transfusion and reduce the incidence of unexpected antibodies.
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Objective To explore the applicable value of microcolumn gel immunoassay(MGIA) in transfusion-related experiments(blood typing, cross matching, antibody titration), and carry out its methodical evaluation. Methods Fifteen anti-Rh D positive samples from 55 Rh D negative patients, twenty-one cases of discrepant blood typing and twenty-nine cross matching positive samples were studied by applying MGIA and routine tube test simultaneously. Antibody titer data from 853 pregnant women with type O were brought into statistics. Results In 55 Rh D negative samples, the positive rate of Rh D antibody tested by MGIA and tube test was 27.27%(15/55) and 21.82 % (12/55) respec-tively,and the samples with titer 1:4 above got the coincident results by the two methods. For twen-ty-one discrepant blood typing samples, 11 cases with weak reaction showed discrepant results by MGIA;however, all samples showed weak reaction by tube test. In 29 samples with cross matching positive by MGIA,2 cases were confirmed to be negative by tube test. For the pregnant women with type O,IgG antibody titer abnormal ratio was 33.18%(144/434) if their respective husbands was with type A,33.17%(139/419) if their respective husbands was with type B.Conclusion MGIA is charac-teristic of convenience, fastness and reliability of test results, but its false-positive or false-negative should be paid attention to. When abnormal results occur, traditional tube test as well asmicroscopic examination should be performed in parallel.
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Objective To study the therapeutic efficacy of cryoprecipitate in the treatment of disseminated intravascular coagulation(DIC).Methods 28 healed cases of DIC from 2006 to 2007 were enrolled in the study.The changes of thrombin time(TT),prothrombin time(PT),activated partial thromboplastin time(APTT)and fibrinogen(Fbg)were compared and analyzed before and after cryoprecipitate infusion.Results The therapeutic efficacy of 28 cases was satisfactory after cryoprecipitate treatment,and the findings of TT,PT,APTT and Fb were improved.Conclusion The cryoprecipitate plays an important role in the treatment of DIC.Cryoprecipitate offers various kinds of blood coagulation factors for control of DIC,provides the opportunity of successful remedy,and improves the treatment achievement ratio.
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Objective:To study on significance of ABO genotyping.Methods:To use the methods of polymerase chain reaction sequence specific primers(PCR SSP) for genotyping of ABO blood group and observation ABO gene polymorphism as well as identification of doubt sample.Results:The reliability of the genotyping for ABO blood group was proved by testing DNA samples previously known genotypes.The results of genotyping for 104 healthy and unrelated HAN individuals were correspond with serological phenotypes.The method of ABO genotyping was applied for clinical pre transfusion ABO typing,pre delivery fetal ABO typing,parenting test and subgrouptyping.Conclusion:The method of ABO genotyping may correct typing for doubt sample of ABO serological typing.