Red blood cell alloantibodies in healthy egyptian blood donors

Background: Alloantibodies are antibodies that are produced in response to foreign antigens, the main stimuli responsible for erythrocyte alloantibodies in healthy adult donors are previous pregnancies and transfusions. Red blood cell [RBC] alloantibodies, especially IgG class, are clinically significant because of the association with hemolytic disease of newborns [HDN], hemolytic transfusion reaction [HTR] and a significant reduction in lifespan of transfused red blood cells. It has been stated that hemolytic reactions due to erythrocyte alloantibodies in donor blood is a relatively rare occurrence; however, they can occasionally cause severe transfusion reaction, particularly if given to infants and in the setting of massive transfusion

Objective: We aimed in this study to screen healthy Egyptian blood donors for the presence of red blood cells alloantibodies in a trial to prevent complications of blood transfusion, other secondary possible outcomes are to reveal the differential frequency of these alloantibodies among donors with previous blood transfusion, multiple pregnancies, different age groups and gender

Subjects and Methods: This study was carried out on 200 healthy Egyptian blood donors coming to Ain Shams University Hospitals Blood Banks. Data was collected on: gender, age, frequent donor or first time to donate, history of previous blood transfusion, number of pregnancies [in female donors], history of hepatitis or other viral infection, history of diabetes mellitus, hypertension, and history of recent surgery

Results: Sera from donors was subjected to alloantibody screening by manufacturer’s antibody screening cells [Grifols I+II+III], when positive screening test, alloantibodies identification was done by manufacturer’s antibody identification panel [Grifols], which consists of 11 panels. Out of the 200 donors, alloantibodies were detected in 8 donors [4%], a percent which is higher than other studies, may be due to the smaller sample size, alloantibodies were: anti-Kell in 1 case [12.5%], anti-M in 1 case [12.5%], and anti-C in 1 case [12.5%], anti-c in 1 case [12.5%], and anti P in 1 case [12.5%], and 3 [37.5%] cases were non-specific antibodies, 130[65%] of donors were males and 70 [35%] were females with a male to female ratio 1.8:1, their ages ranged from 19 years to 65 years with median of 32 years

Conclusion: Relation between alloantibodies and gender, multipara, repeated blood transfusion and previous surgeries was done showing statistically significance of previous surgeries and presence of allo-antibodies

Reducing health risk behaviors in adolescent girls through counseling and support group

Usually adolescents lack knowledge, experience and maturity to avoid the risks that confront them. Counseling can help young people to get back on track. Aims of this study were to assess risk taking behaviors among adolescent girls and to reduce such risky behaviors through counseling and support group. A descriptive research design was utilized. Study was carried out at El-Zahraa Governmental School for girls; 336 girls age ranged from 12-20 years were chosen as a proportional random sample from the school. Three tools were used developed by the researchers: 1- A questionnaire sheet to collect data regarding -socio-demographic characteristics, risky behaviors among the study subjects and 2- Three levels rating scale to measure adolescents' degree of satisfaction with life. 3- Scholastic achievement sheet. And practical part which includes structured counseling based on detected risky behaviors for students, teachers and parents to act as a support group. Pilot study was carried out on 10 girls. Results revealed that adolescents disclosed eight health risky behaviors, [28.8% and 23.8%] shows high and poor satisfaction with life respectively, scholastic achievement was [39.9%] for excellent. A significant statistical relation was found between satisfaction with life and scholastic achievements [p> 0.001]. Counseling reveals success of researcher's interventions in gaining a promise to correct some risky behaviors, however, still more counseling, psychological support are needed to overcome other problems. It was recommended that adolescents should be involved in different activities and families'support, peers and the community at large is critical to long-term behavior change

Antinucleosome antibodies as early predictors of lupus nephritis

Background: the role of the nucleosome in the induction of antibody response in lupus mediated tissue damage especially glomerulonephritis, may provide a new insight in the early diagnosis and alternative therapeutic developments in systemic lupus erythematosus [SLE]

Objectives: to evaluate the frequency and specificity of antinucleosome antibody expression in SLE patients in relation to disease activity. Also, to assess their predictive value in subclinical lupus nephritis

Methods: this study included 26 patients with SLE and 52 control subjects [26 were healthy and 26 had juvenile rheumatoid arthritis "JRA"]. Among lupus patients, 15 had clinical evidence of renal involvement. After clinical evaluation to calculate the SLE disease activity index [SLEDAI], measurements of urinary microalbumin and serum antinucleosome antibodies [antinucleosome specific, antihistone and anti ds-DNA antibodies by ELISA] were performed. Patients without clinical evidence of renal involvement were followed up for one year and measurement of urinary microalbumin was repeated at the end of the study period. Those who later developed microalbuminurea were categorized as patients with subclinical lupus nephritis

Results: the expression of the 3 studied antinucleosome antibodies was significantly higher among lupus patients as compared to JRA patients and healthy controls. Seropositivity for one or more antinucleosome antibodies was elicited in 84.5% of lupus patients. Serum levels of the 3 antinucleosome antibodies were significantly higher among lupus patients with clinical nephritis than those without nephritis. ANSAb had higher sensitivity, specificity and positive and negative predictive values for subclinical lupus nephritis [100%] than antihistone and anti ds-DNA antibodies [43%, 100%, 100% and 50% respectively for either antibodies]. All patients with lupus nephritis were seropositive for at least one of the antinucleosome antibodies, while those without clinical or subclinical nephritis were seronegative for the 3 antinucleosome antibodies. In 27.3% of patients with lupus nephritis, ANSAB was positive while both antihistone and ds-DNA antibodies were negative. Antinucleosome antibodies correlated positively with SLEDAI and cumulative steroid dose and negatively with corrected creatinine clearance

Conclusions: the observed sensitivity and specificity of antinucleosome specific antibodies as early indicators of subclinical lupus nephritis appear encouraging and deserve further analysis on a large scale in order to confirm their validity, especially in the anti ds-DNA seronegative lupus patients