Correlation Analysis of Hemolytic Transfusion Reaction Induced by Low Titer Antibody / 中国实验血液学杂志

OBJECTIVE@#To establish the diagnostic process of low titer blood group antibody in the occurrence of adverse reactions of hemolytic transfusion.@*METHODS@#Acid elusion test, enzyme method and PEG method were used for antibody identification. Combined with the patient's clinical symptoms and relevant inspection indexes, the irregular antibodies leading to hemolysis were detected.@*RESULTS@#The patient's irregular antibody screening was positive, and it was determined that there was anti-Lea antibody in the serum. After the transfusion reaction, the low titer anti-E antibody was detected by enhanced test. The patient's Rh typing was Ccee, while the transfused red blood cells were ccEE. The new and old samples of the patient were matched with the transfused red blood cells by PEG method, and the major were incompatible. The evidence of hemolytic transfusion reaction was found.@*CONCLUSION@#Antibodies with low titer in serum are not easy to be detected, which often lead to severe hemolytic transfusion reaction.

The Results of External Proficiency Tests to Prevent Transfusion-transmitted Virus Infection: There Is a Need for a Quality Assurance Program for Donor Screening Tests to Prevent Blood-borne Virus Infections / 대한수혈학회지

BACKGROUND: We analyzed the results of external proficiency tests for HBsAg, anti-HCV and anti-HIV, and these tests are currently used for blood donor screening in Korea. METHODS: The external proficiency testing (EPT) data was retrospectively collected from 2001 to 2009 from the Korean Association of Quality Assurance for Clinical Laboratories, and this association includes those institutes that have blood centers. The pooled patient sera or converted sera from the plasma were used for EPT. The year 2004 data includes the Recombinant HBsAg variant (Gly/Arg 145). RESULTS: A total 806 institutes participated in this evaluation. The average discordant rate for HBsAg, anti-HCV and anti-HIV in the blood centers was 0.2%, 0.6% and 1.0%, respectively for the years 2001~2009. For the HBsAg test, the discordant rate was less than 0.5% in 2009, yet there was a much higher rate (1.6~22.2%) in 2004 when using the recombinant HBsAg variant. CONCLUSION: HBV variants or low positive antigen or antibody titers were problematic in the current clinical laboratory, and so a systematic quality assurance program should be conducted with using control materials.

Establishment of a Korean Hepatitis B Surface Antigen Low Titer Performance Panel for Performance Validation of Hepatitis B Surface Antigen Immunoassays / 대한수혈학회지

BACKGROUND: A range of well characterized materials are needed for validating the performance of hepatitis B surface antigen (HBsAg) immunoassays. These materials are purchased currently from overseas manufacturers at a high cost and with limited quantity. This study was conducted to establish an HBsAg low titer performance panel for use as a national standard for validation of HBsAg immunoassays in Korea. METHODS: 476 plasma units reactive on blood donor screening were collected HBsAg was tested using 3 enzyme immunoassays (EIA) and 1 chemiluminescence immunoassay (CIA). Units reactive on the CIA assay or on 2 or more immunoassays were subjected to hepatitis B virus (HBV) DNA quantification, HBV genotyping and subtyping. Units reactive on HBV DNA quantification were confirmed for HBsAg by neutralization. Candidates for the panel were subjected to a collaborative study performed at 7 laboratories using 7 immunoassays. RESULTS: Eleven HBsAg positive units were selected for the low titer performance panel based on HBsAg immunoassay, HBV DNA quantification, HBV genotyping and subtyping results. The range of the HBsAg concentration of the panel members was 0.05~1.28 IU/mL. Two HBsAg negative units were also included as negative controls. CONCLUSION: As a result of this study, a low titer performance panel [KFDA standard (08/028); HBsAg low titer performance panel (BTRL HBV/LP)] for validation of HBsAg immunoassays has been established as a Korean national standard. Use of this panel will improve performance assessment of HBsAg immunoassays. Because the performance of immunoassays cannot be assessed properly with a limited number of panels, continuous efforts are needed to develop a range of performance panels.

A Case of Severe Low-Titer Cold-Hemagglutinin Disease / 대한임상병리학회지

Most patients suffering from acute cold-hemagglutinin disease(CHAD) have cold-agglutinin titers well over 1000 which respond poorly to corticosteroids treatment. However, good results with corticosteroids have been reported in some patients with severe low-titer CHAD. We report the case of severe low-titer CHAD which responded well to corticosteroids treatment. A 7-year-old girl with unremarkable prior history was admitted in July 1999 with a three-day history of high fever and black-colored urine. Direct antiglobulin test using polyvalent and anti-C3d monovalent antisera were positive. Cold-agglutintin titer was as high as 1:256 at 4degrees C, 1:32 at 25degrees C and less than 1:4 at 37degrees C. The serum contained cold autoantibodies against both adult and cord blood erythrocytes. Washed and prewarmed red blood cells were transfused. The girl experienced prompt relief of fever and hemolysis and improvement of her general condition after corticosteroids treatment.

STUDIES ON PREPARATION OF HBe SYSTEM EIA KIT WITH LOW TITER ANTI-HBe SERUM / 中国免疫学杂志

This paper Introduced the reagentkit prepared by specific anti-HBewhich could be easily purified byaffinitive chromatography columnwith low titer anti-HBe serum.Iteither open up a new way for rowmaterials or enhance the specificityand sensitivity of e system detection