• Korean Journal of Clinical Laboratory Science
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• v.48 no.1
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• pp.36-40
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• 2016

Red blood cell (RBC) alloimmunization results from genetic disparity of RBC antigens between donor and recipients. The discrepancy of RBC antibody screening test occurs when the results of red cell tests do not agree with those of the serum test. In order to select the proper blood units for transfusion, clarification of the cause of discrepancies is essential. The RBC antibody screening test is an easy, quick, and reliable method for detection of clinically significant antibodies. Antibody screening and identification is recommended prior to transfusion to determine whether there is blood group incompatibility. We reported that phenotyping for E, D, M, E+c, and C+e antibody screening test should be extended. Therefore, these results indicate that anti-D and anti-E alloantibodies were major risk factors for haemolytic disease of the newborn or delayed haemolytic transfusion reactions in this study population. We suggested that its antibody screening be adapted to blood safety interventions. Targeted screening of selected recipients at risk offers less value than universal antibody screening, and more research is needed to determine the real incidence of this national condition.

• Korean Journal of Clinical Laboratory Science
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• v.45 no.4
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• pp.164-169
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• 2013

Red cell alloantibodies other than naturally occurring anti-A or anti-B are called unexpected red cell antibodies, and can be detected by performing an antibody screening. The frequency and distribution of unexpected antibody identified in Asan Medical Center were analyzed. We investigated a total of 135,238 cases of antibody screening test in AMC for 3 years from 2010 to 2012. Using column agglutination techniques, antibody identification tests were performed for the cases with positive antibody screening. Among 135,238 cases, 854 (0.6%) cases showed positive results of antibody screening test. In the order of frequency, 284 (33.3%) anti-Rh, 89 (10.4%) anti-MNS, 62 (7.3%) anti-Lewis, 34 (4.0%) anti-Kidd, 10 (1.2%) anti-Duffy, and 9 (1.1%) anti-P were identified. Multiple antibodies were detected in 199 (23.3%) cases. Among 381 subjects investigated for transfusion history, 299 (78.5%) had history of transfusion while 82 (21.5%) had unknown history. Thus the incidence of unexpected antibody was higher in the group with history of transfusion than the group without (p<0.001). Also, among 435 subjects investigated for the history of pregnancy, 46 (10.6%) had no history while 389 (89.4%) had history of pregnancy, showing higher incidence of unexpected antibody in the group with history of pregnancy than the group without pregnancy (p<0.001). Evaluated amounts and frequency of antigen exposure due to transfusion and pregnancy is suggested to increase the frequency of identification of unexpected antibody.

• Korean Journal of Clinical Laboratory Science
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• v.42 no.2
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• pp.63-70
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• 2010

Antibody screening and identification tests before blood transfusion are important because unexpected red antibodies can cause acute or delayed hemolytic transfusion reactions. Although a tube method was used for detecting unexpected antibodies, a column agglutination method has recently been used because of its simple procedure and a high detection of warm antibodies. This study investigated the frequency and distribution of unexpected antibodies in transfusion candidates during the recent 5 years, and transfusion characteristics in the identified cases. From January 2005 to December 2009, 46,923 sera of the cases from E hospital were screened and 98 sera were identified by the DiaMed-ID System. 272 cases (0.58%) showed positive results out of all 46,923 cases that underwent unexpected antibodies screening. Among them, unexpected antibodies were identified in 98 cases. The anti-Rh antibodies included in warm antibodies were the most frequently detected in 47 cases (47.96%). Anti-Lewis and anti-MNSs antibodies were detected in 11 cases (11.22%) and 6 cases (6.12%), respectively. Unidentified antibodies were detected in 6 cases (6.12%). Among the patients with unexpected antibodies, 43 cases (43.88%) had a history of previous transfusion. Anti-E was the most frequently detected antibody (4/14 cases, 30.77%) in the cases who had a previous history of transfusion and showed different screening results from negative to positive, This study may provide the basic data for the frequency and characteristics of red cell antibodies.

• Journal of Yeungnam Medical Science
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• v.30 no.1
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• pp.21-24
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• 2013

Hemolytic disease in a newborn that causes early jaundice is common. It is often due to the Rh (D) and ABO incompatibility, but rarely due to unexpected antibodies. Among these unexpected antibodies, the anti-$Di^a$Dia antibody rarely occurs. The anti-$Di^a$ antibody was observed in the serum and red-cell eluate of an infant, and in the serum of his mother. The frequency of the appearance of the $Di^a$ antigen in the Korean population is estimated to be 6.4-14.5%. This paper reports a case of hemolytic disease in a newborn associated with the anti-$Di^a$ antibody. A full-term male infant was transferred to the authors' hospital due to hyperbilirubinemia the day after his birth. The laboratory data indicated a hemoglobin value of 11.6 g/dL, a reticulocyte count of 10.6%, a total bilirubin count of 14.4 mg/dL, a direct bilirubin count of 0.6 mg/dL, and a positive result in the direct Coombs' test. Due to the identification of an irregular antibody from the maternal serum, an anti-$Di^a$ antibody was detected, which was also found in the eluate made from the infant's blood. The infant had been treated with phototherapy and intravenous immunoglobulin since the second day after his birth and was discharged due to an improved condition without exchange transfusion. Therefore, in cases of iso-immune hemolytic disease in a newborn within 24 hours from birth who had a negative result in an antibody screening test, the conduct of an anti-$Di^a$ antibody identification test is recommended due to the suspicion of an anti-$Di^a$ antigen, followed by early administration of intravenous immunoglobulin.

• Korean Journal of Clinical Laboratory Science
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• v.49 no.4
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• pp.390-394
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• 2017

Unexpected antibody screening and identification tests are highly important in the prevention of hemolytic transfusion reactions. Therefore, it is highly recommended to perform unexpected antibody screening test in all transfusion candidates. Here, the frequency and distribution of unexpected antibodies identified in Jeju for the past 3 years were evaluated. Between Jan 2014 and Dec 2016, unexpected antibody screening test was performed for 10,360 sera of transfusion candidates in Jeju general hospital using a column agglutination method with the Ortho BioVue system (Ortho-clinical Diagnostics, Raritan, NJ, USA). Eighty-seven (0.84%) of 10,360 cases that underwent unexpected antibiotics screening showed positive results. Among them, unexpected antibodies were identified in 41 cases (0.40%). Unidentified antibodies were detected in 8 cases (19.51%) and autoantibodies were detected in 3 cases (7.32%). The anti-E antibody included in warm antibodies were detected most frequently in 8 cases (19.51%); 6 cases (14.63%) of anti-E + anti-c antibody and 3 cases (7.32%) of $anti-Le^a+anti-Le^b$. $Anti-Le^a$ and $anti-Le^b$ antibodies were detected in 2 cases (4.88%), respectively. The anti-D, $anti-Di^a$, $anti-Fy^b$, $anti-Jk^a$, $anti-Jk^b$, anti-M and anti-P1 were detected in 1 case (2.44%). Complex antibodies were detected in 1 case (2.44%) in anti-C+anti-D and anti-E+anti-c+$anti-Jk^b$, respectively. In this study, we analyzed the frequency and distribution of unexpected antibodies in one general hospital for the past 3 years. However, there has been a general increase in multicultural families and foreign workers in Jeju, and it would be a meaningful study to compare the frequency and distribution of unexpected antibodies.

• The Korean Journal of Blood Transfusion
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• v.23 no.2
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• pp.169-172
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• 2012

Lutheran a antigen ($Lu^a$) is detected in 6 to 8% of Caucasians and Africans. In Korean and other Asian populations, it is very rare or nearly absent. Therefore, although $Lu^a$ has a considerable immunizing capacity, sensitization to $Lu^a$ is a rare event. Here we report on a rare case of anti-$Lu^a$ in a 70 year-old female patient with Lu (a-/b+) phenotype and review the relevant literature. Due to the paucity of $Lu^a$ positive panel cells in antibody screening and identification tests, detection of this rare antibody to $Lu^a$ antigen is not feasible. Therefore, we should keep in mind the possibility of the misleading false negative result in detection of antibody to this low incidence antigen.

• Laboratory Medicine Online
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• v.1 no.1
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• pp.64-66
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• 2011

Anti-Sd^a is of no clinical significance, because it rarely causes hemolytic transfusion reactions. Even when its presence is suspected during antibody screening test, further identification of the antibody is usually not performed. We experienced a case of anti-Sd^a in 73 yr-old male patient showing mixed field agglutination by microcolumn agglutination. Antibody specificity could not be identified by conventional antibody identification test, and it was proven to be anti-Sd^a by urine neutralization test. In spite of its little clinical significance, it may give incompatible crossmatching results reacting with Sd^a antigen, which occurs at a high frequency in general population. When incompatible crossmatch results arising from anti-Sd^a are suspected, the problem may be solved by using the urine-neutralized serum of in crossmatching test.

• The Korean Journal of Blood Transfusion
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• v.29 no.3
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• pp.320-327
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• 2018

A 72-year-old man with general weakness visited the outpatient clinic of the hematology department. The patient had been treated under the diagnosis of autoimmune hemolytic anemia for 2 years. His hemoglobin level at the time of the visit was 6.3 g/dL, and a blood transfusion was requested to treat his anemia. The patient's blood type was A, RhD positive. Antibody screening and identification test showed agglutination in all reagent cells with a positive reaction to autologous red blood cells (RBCs). He had a prior transfusion history with three least incompatible RBCs. The patient returned home after receiving one unit of leukoreduced filtered RBC, which was the least incompatible blood in the crossmatching test. After approximately five hours, however, fever, chills, dyspnea, abdominal pain, and hematuria appeared and the patient returned to the emergency room next day after the transfusion. The $anti-Fy^a$ antibody, which was masked by the autoantibody, was identified after autoadsorption using polyethylene glycol. He was diagnosed with an acute hemolytic transfusion reaction due to $anti-Fy^a$ that had not been detected before the transfusion. In this setting, it is necessary to consider the identification of coexisting alloantibodies in patients with autoantibodies and to become more familiar with the method of autoantibody adsorption.

• Korean Journal of Veterinary Service
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• v.36 no.3
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• pp.181-186
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• 2013

This study was conducted to isolate the Actinobacillus pleuropneumoniae (APP) and to find out the distribution of 15 serovars mainly in southern Gyeonggi province, Korea. From July 2011 to Nov. 2012, a total of 2,204 slaughter pigs (110 herds) were inspected for evaluation of APP like pneumonic lesions. 48 (33.8%) APP strains were isolated from the 142 lungs and identified using PCR assays (cps, apx/omlA, biovar). Consequently, the serotype ratio were as in the following; type2 41.7% (n=20), type5 33.3% (n=16), type12 10.4% (n=5), type1 6.2% (n=3), type4 and 7 2.1% (n=1) and unknown 4.2% (n=2). Also serological test was implemented for 452 (83 herds) serum samples randomly collected from above slaughter pigs using commercial ELISA kits. The positive ratio of each serotype for tested pigs were 19.1% (77/404) on [2], 7.1% (32/452) on [3, 6, 8], 6.9% (28/404) on [5a, 5b], 6.2% (28/452) on [4, 7], 2.8% (9/320) on [12], 2.0% (9/452) on [1, 9, 11] and 0.0% (0/452) on [10]. And 49.3% (223/452) of pigs were positive on apxIV antibody. On the basis of latter screening test, the infected farm ratio accounted for 71.1% (59/83) and that was much higher than previously reported data.

• Journal of Microbiology and Biotechnology
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• v.27 no.11
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• pp.1971-1982
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• 2017

Piliated Lactobacillus rhamnosus (pLR) strains possess higher adherent capacity than non-piliated strains. The objective of this study was to isolate and characterize probiotic pLR strains in human fecal samples. To this end, mouse polyclonal antiserum (anti-SpaA) against the recombinant pilus protein (SpaA) of L. rhamnosus strain GG (LGG) was prepared and tested for its reactivity and specificity. With the anti-SpaA, a method combining the de Man, Rogosa, and Sharpe (MRS) agar plating separation and colony immunoblotting (CIB) was developed to isolate pLR from 124 human fecal samples. The genetic and phenotypic characteristics of the resultant pLR isolates were compared by randomly amplified polymorphic DNA (RAPD) fingerprinting, and examination of adhesion to Caco-2 cells, hydrophobicity, autoaggregation, and in vitro gastrointestinal tolerance. Anti-SpaA specifically reacted with three pLR strains of 25 test strains, as assessed by western blotting, immunofluorescence flow cytometry, and immunoelectron microscopy (IEM) assays. The optimized MRS agar separation plus anti-SpaA-based CIB procedure could quantitatively detect $2.5{\times}10^3CFU/ml$ of pLR colonies spiked in $10^6CFU/ml$ of background bacteria. Eight pLR strains were identified in 124 human fecal samples, and were confirmed by 16S RNA gene sequencing and IEM identification. RAPD fingerprinting of the pLR strains revealed seven different patterns, of which only two isolates from infants showed the same RAPD profiles with LGG. Strain PLR06 was obtained with high adhesion and autoaggregation activities, hydrophobicity, and gastrointestinal tolerance. Anti-SpaA-based CIB is a rapid and inexpensive method for the preliminary screening of novel adherent L. rhamnosus strains for commercial purposes.