Serological and immunochemical specificity of a human autoanti-Gerbich-like antibody.

An 85-year-old male with cardiac failure secondary to anaemia had an apparent anti-Ge2 (Ge = Gerbich) in his serum which did not agglutinate his own red cells even though they were Ge-positive in tests with alloanti-Ge. The direct antiglobulin test was negative; however, an antibody with apparent anti-Ge2 specificity was eluted from his red cells. The patient's autoantibody was shown in immunoblotting experiments to react with an antigenic determinant on beta-sialoglycoprotein. This case illustrates that an autoanti-Ge can masquerade as an alloantibody, thereby complicating antibody identification, and implies that the immunochemical specificity of autoanti-Ge2 is different from that of alloanti-Ge2.

IgM anti-D as auto-antibody in a case of 'cold' auto-immune haemolytic anaemia.

A case is reported of an auto-immune haemolytic anaemia caused by IgM anti-D. This antibody, although active at 37 degrees C, gave stronger reactions at lower temperatures and appeared to activate complement. The auto-immune haemolytic anaemia was probably secondary to a non-Hodgkins lymphoma.

Follow-up of normal individuals with a positive antiglobulin test.

Over a period of 20 yr (1962-1982), 67 apparently fit donors at a Regional Blood Transfusion Service were found to have an unexplained positive direct antiglobulin test (DAT). During 1983, 26 were traced and re-tested. 9 still had a positive DAT only 1 of whom had developed autoimmune haemolytic anaemia. 17 had become negative though in 7 of these an autoantibody could still be detected by an enzyme technique. Unlike patients with established autoimmune disorders, the positive DAT individuals were found to have normal T cell subsets though B cells were significantly increased.

Studies on Mv red cells. II. Immunochemical investigations.

The properties of the Mv antigen, a low incidence receptor of the MNSs blood group system, were investigated by serological tests with protease treated red cells and inhibition assays with glycoproteins or peptides from normal and Mv erythrocytes. Our data demonstrate that the Mv receptor represents an allelomorphic form of the 'N' antigen on the Ss sialoglycoprotein, rather than variant of the M receptor on the MN sialoglycoprotein. Anti-Mv plus -N (serum Arm.) reacts with the N, 'N' and Mv antigens, whereas anti-Mv (serum Arch.) is specifically directed against the latter receptor.

Fetomaternal blood group incompatibility studies in placental intervillous thrombosis.

Samples of maternal and fetal blood from 32 cases of placental intervillous thrombosis have been analysed for blood group incompatibility and compared to a control group of 21 cases. No overall link has been demonstrated between intervillous thrombosis and ABO incompatibility. Red cell antibody reactions of all types probably account for only a small proportion of thrombi and it is suggested that the principle mechanism may be a thromboplastin release from the damaged vasculo-syncytial membrane, causing a coagulation of the mixed maternal and fetal cells.

Development of multiple antibodies in an apparently 'protected' Rh D negative mother.

A case is described of a group O Rh (D) negative woman who received a blood transfusion after the delivery of her first infant, blood group O Rh (D) negative. In her second pregnancy anti-S was detected, presumably due to the prior transfusion. The second infant was D+S+ and the direct antiglobulin test on this infant's cells was positive. As no anti-D antibodies were detectable in this pregnancy, the positive antiglobulin test was presumably due to the anti-S. Anti-D immunoglobulin was administered after this pregnancy, but in spite of this the mother developed a strong anti-D antibody. The significance of this 'failure of protection' is discussed in relation to the augmenting affect of antibody development during pregnancy.

Four further examples of anti-Inb detected during pregnancy.

Four further examples of anti-Inb are described. All four were detected during pregnancy in patients from the Asian immigrant community living in the North of England. Anti-Inb, even when an IgG antibody, is unlikely to cause haemolytic disease of the newborn as it seems unable to cross the placenta. Observations are also made on the frequency of the Ina and Inb antigens in both the native English and Asian immigrant populations.

Changes in the inhibition of specific agglutination by plasma due to microvesicles released from human red cells during storage for transfusion.

The progressive appearance of erythrocyte antigenic activity in plasma from donations of human blood taken into acid citrate-dextrose (ACD) and stored at 4 degrees D for transfusion has been studied. It has been shown by specific inhibition tests that A, B, H and P1 activities are associated with membrane-bounded microvesicles which are released from the red cell membrane during the disc-echinocyte-spherocyte shape transformation. Although M group activity appears to be lost from the red cell membrane during storage, significant recovery on the microvesicles is not obtained even though these seem to contain the M and N group intrinsic protein, glycophorin.

The phenotype Ae1B: a probable result of chimerism.

An apparently normal healthy adult with the blood group phenotype Ae1B is described. The unusual ABO group is apparently the result of chimerism, the proportion of the minor population of cells being so small as to be only detectable by absorption and elution techniques.

Studies on Miltenberger class III, V, Mv and Mk red cells. I. Sodium-dodecylsulfate polyacrylamide gel electrophoretic investigations.

The glycoproteins in erythrocyte membrane from individuals exhibiting the rare alleles at the MNSs blood group locus Miltenberger (Mi-) III, V, Mv and Mk were studied by sodium-dodecylsulfate polyacrylamide gel electrophoretic techniques. The results suggest that the genes Mi-III and -V give rise to the formation of Ss sialoglycoproteins whose electrophoretic mobilities are altered. The Mi-V alteration is additionally associated with a decreased MN glycoprotein content. The allele Mv leads to a decreased Ss glycoprotein content. Data on ordinary Mk and Mk/Mi-III red cells suggest that the gene complex Mk does not give rise to the synthesis of Ss glycoprotein.

Changes in the agglutinability of red cells and the inhibition of specific agglutination by plasma from human blood taken into ACD and stored at 4 degrees C.

The effect of storage in ACD at 4 degrees C on red cell agglutinability and the inhibitory properties of the plasma to blood group reagents has been studied. It was found that the variability demonstrated was related to the origin of the reagent used, particularly between human and on-human sources. The significance of these findings with regard to biochemical and morphological changes in blood on storage is discussed.

A new antibody specificity, anti-Rga, reacting with a red cell and serum antigen.

A new antibody specificity, anti-Rga, which detects an inherited antigen on red cells and in serum, reacts with 97% of individuals in the British population.

Anti-Kell (K1) in ascitic fluid.

The presence of anti-Kell (K1) in the ascitic fluid of a patient with adenocarcinoma is described. The antibody has persisted for over 3 years. The anit-K1 together with the anti-A and anti-B also present in the fluid, is compared with antibodies present in the patient's serum.