Subject(s)
Humans , Male , Female , Adult , Middle Aged , Blood Donors , Blood Transfusion , Deltaretrovirus Antibodies/blood , HTLV-I Infections/transmission , HTLV-II Infections/transmission , Seroepidemiologic Studies , Bisexuality , Heterosexuality , Risk Factors , Sexually Transmitted Diseases , Substance Abuse, Intravenous , Substance-Related DisordersSubject(s)
Humans , Male , Female , Adult , Middle Aged , Deltaretrovirus Antibodies/blood , HTLV-I Infections/transmission , HTLV-II Infections/transmission , Blood Donors , Seroepidemiologic Studies , Blood Transfusion , Risk Factors , Heterosexuality , Sexually Transmitted Diseases , Bisexuality , Substance-Related Disorders , Substance Abuse, IntravenousABSTRACT
HTLV-I and HTLV-II are two related retroviruses that are transmitted by sexual contact, breast feeding, blood transfusion and needle sharing. In this study the prevalence of HTLV-I and HTLV-II was evaluated in voluntary blood donors as a measure of the infection in the general population. Samples were tested by a gelatine particle agglutination test and repeatedly reactive samples were confirmed by Western blot tests (WBT), enriched with recombinant rgp21, rgp461 y rgp4611 proteins, which differentiates HTLV-I and HTLV-II antibodies. Of 19,426 samples, 40 were repeatedly reactive by particle agglutination (0.21%). When analyzed by WBT, 6 met the criteria for HTLV-I (0.036%), 2 for HTLV-II (0.01%) and 1 for HTLV-I/II, 13 samples were indeterminate and 18 were negative. The prevalence is low and comparable to that from non endemic countries. Screening for anti HTLV-I/II antibodies is necessary to prevent transmission through blood transfusions.
Subject(s)
HTLV-I Infections/transmission , HTLV-II Infections/transmission , Adolescent , Adult , Aged , Agglutination Tests/methods , Argentina , Blood Donors , Blotting, Western , Female , HTLV-I Antibodies/analysis , HTLV-II Antibodies/analysis , Human T-lymphotropic virus 1/immunology , Human T-lymphotropic virus 2/immunology , Humans , Male , Middle Aged , PrevalenceABSTRACT
HTLV-I and HTLV-II are two related retroviruses that are transmitted by sexual contact, breast feeding, blood transfusion and needle sharing. In this study the prevalence of HTLV-I and HTLV-II was evaluated in voluntary blood donors as a measure of the infection in the general population. Samples were tested by a gelatine particle agglutination test and repeatedly reactive samples were confirmed by Western blot tests (WBT), enriched with recombinant rgp21, rgp461 y rgp4611 proteins, which differentiates HTLV-I and HTLV-II antibodies. Of 19,426 samples, 40 were repeatedly reactive by particle agglutination (0.21
). When analyzed by WBT, 6 met the criteria for HTLV-I (0.036
), 2 for HTLV-II (0.01
) and 1 for HTLV-I/II, 13 samples were indeterminate and 18 were negative. The prevalence is low and comparable to that from non endemic countries. Screening for anti HTLV-I/II antibodies is necessary to prevent transmission through blood transfusions.
Subject(s)
Blood Donors , HTLV-I Infections/epidemiology , HTLV-II Infections/epidemiology , Adolescent , Adult , Aged , Argentina/epidemiology , Blotting, Western , Deltaretrovirus Antibodies/blood , Female , Human T-lymphotropic virus 1/immunology , Human T-lymphotropic virus 2/immunology , Humans , Male , Mass Screening , Middle Aged , PrevalenceABSTRACT
Se describe el caso de un paciente de 24 años de edad con anemia aplástica (AAS) tratada con globulina antilinfocítica (GAL) de origen equino, que desarrolla como complicación un grave cuadro de anemia hemolítica heteroinmune mediada por anticuerpos panaglutinantes anti-especie presentes en al GAL. La reactividad adqurida por el paciente en la prueba de Coombs directa, así como en la investigación de anticuerpos irregulares y en los tests de compatibilidad transfusional se explica por la existencia en el suero antiglobulina humana (SAGH) comercial de anticuerpos que reaccionan con un componente globulínico compartido por los sueros humanos y equino. La neutralización del SAGH con la propia GAL administrada al paciente removió esos anticuerpos de reacción cruzado, resultando de gran utilidad para poder llevar a cabo confiablemente la sprueba de compatibilidad transfusional y de detección de anticuerpos séricos
Subject(s)
Humans , Adult , Male , Anemia, Aplastic/therapy , Anemia, Hemolytic/etiology , Antilymphocyte Serum/adverse effects , Anemia, Aplastic/complications , Coombs Test , Hemolysis , Antilymphocyte Serum/therapeutic useABSTRACT
Se describe el caso de un paciente de 24 años de edad con anemia aplástica (AAS) tratada con globulina antilinfocítica (GAL) de origen equino, que desarrolla como complicación un grave cuadro de anemia hemolítica heteroinmune mediada por anticuerpos panaglutinantes anti-especie presentes en al GAL. La reactividad adqurida por el paciente en la prueba de Coombs directa, así como en la investigación de anticuerpos irregulares y en los tests de compatibilidad transfusional se explica por la existencia en el suero antiglobulina humana (SAGH) comercial de anticuerpos que reaccionan con un componente globulínico compartido por los sueros humanos y equino. La neutralización del SAGH con la propia GAL administrada al paciente removió esos anticuerpos de reacción cruzado, resultando de gran utilidad para poder llevar a cabo confiablemente la sprueba de compatibilidad transfusional y de detección de anticuerpos séricos (AU)
Subject(s)
Humans , Adult , Male , Anemia, Aplastic/therapy , Anemia, Hemolytic/etiology , Antilymphocyte Serum/adverse effects , Anemia, Aplastic/complications , Antilymphocyte Serum/therapeutic use , Hemolysis , Coombs Test , Anemia, Aplastic/complicationsABSTRACT
A 24-year-old male patient with a severe aplastic anemia (SAA) was treated with equine-antilymphocyte globulin (ALG). As complication of this treatment he developed a severe heteroimmune hemolytic anemia mediated by anti-species pan-agglutinin antibodies present in ALG. In spite of the fact that ALG is absorbed with red-cell stroma and platelets to remove anti-erythrocyte and anti-platelet contaminating antibodies, often only partial absorption is achieved, and the remaining antibodies are passively acquired by the recipient. Neutropenia and especially thrombocytopenia are usual complications of this treatment, but it is also possible to detect anti-erythrocyte antibodies in the serum and on the red cells of those patients. However, the unusual severity of the hemolysis suffered by our patient, with a striking decrease of the hemoglobin levels (Fig. 1) can be ascribed to the administration of ALG at a time at which the hematocrit was close to normal as a result of the previous administration of anabolics. It is likely that in severely anemic patients, with a high transfusional demand, such a hemolytic episode may remain undetected. The patient acquired reactivity to the direct antiglobulin test, as well as the positive results of investigation of unexpected antibodies and compatibility testing can be accounted for by the fact that commercial antihuman globulin serum (AGS) contains antibodies reacting with a globulin component shared by human and horse sera. Neutralization of AGS with ALG administered to the patient removed those cross-reacting antibodies, making it possible to perform reliable transfusion compatibility testing and to rule out the eventual presence of hidden alloantibodies or warm autoantibodies. Neutralized Coombs serum maintained its human antiglobulin properties unaltered (Table 1).(ABSTRACT TRUNCATED AT 250 WORDS)
Subject(s)
Anemia, Aplastic/therapy , Anemia, Hemolytic/etiology , Antilymphocyte Serum/adverse effects , Adult , Antilymphocyte Serum/therapeutic use , Coombs Test , Hemolysis , Humans , MaleABSTRACT
A 24-year-old male patient with a severe aplastic anemia (SAA) was treated with equine-antilymphocyte globulin (ALG). As complication of this treatment he developed a severe heteroimmune hemolytic anemia mediated by anti-species pan-agglutinin antibodies present in ALG. In spite of the fact that ALG is absorbed with red-cell stroma and platelets to remove anti-erythrocyte and anti-platelet contaminating antibodies, often only partial absorption is achieved, and the remaining antibodies are passively acquired by the recipient. Neutropenia and especially thrombocytopenia are usual complications of this treatment, but it is also possible to detect anti-erythrocyte antibodies in the serum and on the red cells of those patients. However, the unusual severity of the hemolysis suffered by our patient, with a striking decrease of the hemoglobin levels (Fig. 1) can be ascribed to the administration of ALG at a time at which the hematocrit was close to normal as a result of the previous administration of anabolics. It is likely that in severely anemic patients, with a high transfusional demand, such a hemolytic episode may remain undetected. The patient acquired reactivity to the direct antiglobulin test, as well as the positive results of investigation of unexpected antibodies and compatibility testing can be accounted for by the fact that commercial antihuman globulin serum (AGS) contains antibodies reacting with a globulin component shared by human and horse sera. Neutralization of AGS with ALG administered to the patient removed those cross-reacting antibodies, making it possible to perform reliable transfusion compatibility testing and to rule out the eventual presence of hidden alloantibodies or warm autoantibodies. Neutralized Coombs serum maintained its human antiglobulin properties unaltered (Table 1).(ABSTRACT TRUNCATED AT 250 WORDS)
Subject(s)
Anemia, Hemolytic, Autoimmune/complications , Carcinoma, Squamous Cell/complications , Ovarian Neoplasms/complications , Adult , Anemia, Hemolytic, Autoimmune/therapy , Blood Transfusion , Carcinoma, Squamous Cell/surgery , Female , Hematologic Tests , Humans , Ovarian Neoplasms/surgery , Prednisone/therapeutic useSubject(s)
Cold Temperature/adverse effects , Hemoglobinuria, Paroxysmal/etiology , Hemolysin Proteins/immunology , Anemia, Hemolytic, Autoimmune/diagnosis , Antibody Specificity , Diagnosis, Differential , Female , Hemoglobinuria, Paroxysmal/diagnosis , Hemoglobinuria, Paroxysmal/immunology , Humans , Middle AgedABSTRACT
Se presenta un nuevo caso de asociacion de anemia hemolitica autoinmune (AHAI) con neoplasia de ovario, y se efectua revision de la literatura. Se trata de una paciente de 29 anos de edad que consulta en el noveno dia de su puerperio por anemia e ictericia. Al examen fisico se encontraron como datos de mayor interes, importante hepatomegalia y un tumor en hipogastrio que al examen ginecologico se interpreto como una formacion anexial derecha.Los estudios complementarios demostraron un cuadro de hiperhemolisis y una prueba de Coombs directa positiva de tipo IgM + complemento, evidenciando el autoanticuerpo especificidad anti-I.Ante la falta de respuesta al tratamiento de la anemia mediante corticosteroides, se decidio someter a la paciente a una laparotomia exploradora, tratando de relacionar la tumoracion abdominal con la hiperhemolisis. En el acto operatorio se descubrio un blastoma de ovario y nodulos de aspecto metastasico en higado. Se practico una anexohisterectomia total. La anatomia patologica informo carcinoma anaplasico de ovario derecho con diseminacion al ovario contralateral y al higado. Luego de la cirugia la anemia revirtio completamente, continuandose el tratamiento con poliquimioterapia hasta el momento actual
Subject(s)
Adult , Humans , Female , Anemia, Hemolytic, Autoimmune , Carcinoma, Squamous Cell , Ovarian NeoplasmsABSTRACT
Se presenta un nuevo caso de asociacion de anemia hemolitica autoinmune (AHAI) con neoplasia de ovario, y se efectua revision de la literatura. Se trata de una paciente de 29 anos de edad que consulta en el noveno dia de su puerperio por anemia e ictericia. Al examen fisico se encontraron como datos de mayor interes, importante hepatomegalia y un tumor en hipogastrio que al examen ginecologico se interpreto como una formacion anexial derecha.Los estudios complementarios demostraron un cuadro de hiperhemolisis y una prueba de Coombs directa positiva de tipo IgM + complemento, evidenciando el autoanticuerpo especificidad anti-I.Ante la falta de respuesta al tratamiento de la anemia mediante corticosteroides, se decidio someter a la paciente a una laparotomia exploradora, tratando de relacionar la tumoracion abdominal con la hiperhemolisis. En el acto operatorio se descubrio un blastoma de ovario y nodulos de aspecto metastasico en higado. Se practico una anexohisterectomia total. La anatomia patologica informo carcinoma anaplasico de ovario derecho con diseminacion al ovario contralateral y al higado. Luego de la cirugia la anemia revirtio completamente, continuandose el tratamiento con poliquimioterapia hasta el momento actual
