Autoimmune hemolytic anemia predominantly associated with IgA anti-E and anti-c. 2002

Young Ae Lim, and Moon Kyu Kim, and Bong Hak Hyun
Department of Laboratory Medicine, Ajou University School of Medicine, Suwon, Korea.

A patient with warm autoimmune hemolytic anemia (AIHA) due to predominance of immunoglobulin A (IgA) with an Rh specificity, considered to be the first case in Korea, is described. A 13-year-old male patient with severe hemolytic anemia showed a weak reactivity (1+) in the direct antiglobulin test (DAT) by using anti-IgG antiglobulin reagent. This finding, however, could not fully explain the patient's severe AIHA. When anti-IgA reagent was used for the DAT, strong reactivity (4+) was observed and free anti-E and anti-c autoantibodies were also detected by anti-IgA and anti-IgG reagents. The patient's hemoglobin began to rise with the administration of steroids. Because RBCs coated with multiple types of immunoglobulins are associated with more severe hemolysis than those only with IgG, the DATs using anti-IgA and other reagents are needed for the correct diagnosis when the result of DAT is not compatible with patient's clinical manifestations.

UI MeSH Term Description Entries
D007070 Immunoglobulin A Represents 15-20% of the human serum immunoglobulins, mostly as the 4-chain polymer in humans or dimer in other mammals. Secretory IgA (IMMUNOGLOBULIN A, SECRETORY) is the main immunoglobulin in secretions. IgA,IgA Antibody,IgA1,IgA2,Antibody, IgA
D007723 Korea Former kingdom, located on Korea Peninsula between Sea of Japan and Yellow Sea on east coast of Asia. In 1948, the kingdom ceased and two independent countries were formed, divided by the 38th parallel.
D008297 Male Males
D003298 Coombs Test A test to detect non-agglutinating ANTIBODIES against ERYTHROCYTES by use of anti-antibodies (the Coombs' reagent.) The direct test is applied to freshly drawn blood to detect antibody bound to circulating red cells. The indirect test is applied to serum to detect the presence of antibodies that can bind to red blood cells. Anti-Human Globulin Consumption Test,Antiglobulin Consumption Test,Antiglobulin Test,Coombs' Test,Antihuman Globulin Consumption Test,Direct Antiglobulin Test,Direct Coombs Test,Indirect Antiglobulin Test,Indirect Coombs Test,Anti Human Globulin Consumption Test,Antiglobulin Consumption Tests,Antiglobulin Test, Direct,Antiglobulin Test, Indirect,Antiglobulin Tests,Antiglobulin Tests, Direct,Antiglobulin Tests, Indirect,Consumption Test, Antiglobulin,Consumption Tests, Antiglobulin,Coomb Test,Coomb's Test,Coombs Test, Direct,Coombs Test, Indirect,Direct Antiglobulin Tests,Indirect Antiglobulin Tests,Test, Antiglobulin,Test, Antiglobulin Consumption,Test, Coombs,Test, Coombs',Test, Direct Antiglobulin,Test, Direct Coombs,Test, Indirect Antiglobulin,Test, Indirect Coombs,Tests, Antiglobulin,Tests, Antiglobulin Consumption,Tests, Direct Antiglobulin,Tests, Indirect Antiglobulin
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000744 Anemia, Hemolytic, Autoimmune Acquired hemolytic anemia due to the presence of AUTOANTIBODIES which agglutinate or lyse the patient's own RED BLOOD CELLS. Anemia, Hemolytic, Idiopathic Acquired,Autoimmune Haemolytic Anaemia,Autoimmune Hemolytic Anemia,Cold Agglutinin Disease,Hemolytic Anemia, Autoimmune,Acquired Autoimmune Hemolytic Anemia,Anemia, Hemolytic, Cold Antibody,Cold Antibody Disease,Cold Antibody Hemolytic Anemia,Idiopathic Autoimmune Hemolytic Anemia,Agglutinin Disease, Cold,Anaemia, Autoimmune Haemolytic,Anemia, Autoimmune Hemolytic,Autoimmune Haemolytic Anaemias,Autoimmune Hemolytic Anemias,Cold Agglutinin Diseases,Cold Antibody Diseases,Haemolytic Anaemia, Autoimmune
D000918 Antibody Specificity The property of antibodies which enables them to react with some ANTIGENIC DETERMINANTS and not with others. Specificity is dependent on chemical composition, physical forces, and molecular structure at the binding site. Antibody Specificities,Specificities, Antibody,Specificity, Antibody
D001323 Autoantibodies Antibodies that react with self-antigens (AUTOANTIGENS) of the organism that produced them. Autoantibody
D012204 Rh-Hr Blood-Group System Erythrocyte isoantigens of the Rh (Rhesus) blood group system, the most complex of all human blood groups. The major antigen Rh or D is the most common cause of erythroblastosis fetalis. Rh Factors,Rhesus Blood-Group System,Antigen D, Rh Blood Group,Blood-Group System, Rh-Hr,Blood-Group System, Rhesus,Blood-Group Systems, Rh-Hr,Blood-Group Systems, Rhesus,Factor, Rh,Factors, Rh,Rh Factor,Rh Hr Blood Group System,Rh-Hr Blood-Group Systems,Rhesus Blood Group System,Rhesus Blood-Group Systems,System, Rh-Hr Blood-Group,System, Rhesus Blood-Group,Systems, Rh-Hr Blood-Group,Systems, Rhesus Blood-Group

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