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Defining the clinical relevance of red blood cell autoantibodies by Monocyte Monolayer Assay.
Conrado, Marina C A V; D'Avila, Amanda N; Vieira, Juliana B; Bonifacio, Silvia L; Gomes, Francisco C A; Dezan, Marcia R; Oliveira, Valeria B; Ribeiro, Ingrid H; Tucunduva, Luciana T C M; Mendrone-Júnior, Alfredo; Rocha, Vanderson; Dinardo, Carla L.
Afiliación
  • Conrado MCAV; Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil.
  • D'Avila AN; Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil.
  • Vieira JB; Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil.
  • Bonifacio SL; Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil.
  • Gomes FCA; Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil.
  • Dezan MR; Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil.
  • Oliveira VB; Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil.
  • Ribeiro IH; Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil.
  • Tucunduva LTCM; Discipline of Hematology, University of São Paulo School of Medicine, São Paulo, Brazil.
  • Mendrone-Júnior A; Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil.
  • Rocha V; Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, Brazil.
  • Dinardo CL; Discipline of Hematology, University of São Paulo School of Medicine, São Paulo, Brazil.
J Clin Lab Anal ; 32(2)2018 Feb.
Article en En | MEDLINE | ID: mdl-28568311
BACKGROUND: The Monocyte Monolayer Assay (MMA) is an in vitro simulation of red blood cell (RBC) alloantibody behavior. It has been classically applied to predict the risks of post-transfusion hemolytic reactions when transfusing incompatible RBC units. Quantifying erythrophagocytosis by MMA may be an interesting option for situations where there is doubt whether a RBC autoantibody is mediating significant hemolysis. Here, we present three situations involving RBC autoantibodies in which the MMA was decisive for clarifying the diagnosis and choosing the best clinical treatment. CASE REPORT: Case 1. Pregnant patient with severely anemic fetus exhibited warm autoantibody without signs of hemolysis. MMA revealed 30% of monocyte index (MI) highlighting that fetal hemolysis was caused by maternal autoantibody. Prednisone was prescribed with fetal clinical improvement. Cases 2 and 3. Two patients with the diagnosis of mixed auto-immune hemolytic anemia and poor response to corticosteroids were evaluated using MMA. The resulting MI was less than 10% in both cases, suggesting that the cold-agglutinin rather than the warm auto-IgG was responsible for overt hemolysis. Treatment with rituximab was begun, with good clinical response. CONCLUSION: MMA can be used to evaluate the ability of RBC autoantibodies to mediate overt hemolysis. It can be especially useful to determine the role played by cold and warm auto-antibodies in mixed auto-immune hemolytic disease, helping to define the best treatment option.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Autoanticuerpos / Técnicas Citológicas / Eritrocitos / Anemia Hemolítica Tipo de estudio: Diagnostic_studies / Prognostic_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged / Pregnancy Idioma: En Revista: J Clin Lab Anal Asunto de la revista: TECNICAS E PROCEDIMENTOS DE LABORATORIO Año: 2018 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Autoanticuerpos / Técnicas Citológicas / Eritrocitos / Anemia Hemolítica Tipo de estudio: Diagnostic_studies / Prognostic_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged / Pregnancy Idioma: En Revista: J Clin Lab Anal Asunto de la revista: TECNICAS E PROCEDIMENTOS DE LABORATORIO Año: 2018 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Estados Unidos