Healthy blood donors with selective absence of immunoglobulin A: prevention of anaphylactic transfusion reactions caused by antibodies to IgA.
Gel diffusion analysis of sera from 73,569 healthy volunteer blood donors revealed apparent lack of IgA in 113 (1:650) samples, all with normal levels of IgG and IgM. Of these, 30 sera had low levels of IgA, while the remaining 83 had no IgA detectable by a more sensitive hemagglutination inhibition assay. The frequency of absent IgA (algA) was 1:886. High-titer anti-IgA was detected in the sera of 13 algA donors; only two had any known history of parenteral injection of IgA. Passive transfusion of high-titer anti-IgA in the units of blood elicited no clinical reaction in the recipients. Precipitating antibodies to ruminant IgM were present in 14 of the 83 donors. The incidence of hepatitis B surface antigen (HB-sAg), anti-HB-sAG, and antinuclear antibodies was the same in IgA-deficient and control sera. The algA donors form a unique resource for blood components for the clinical management of patients with anapylactic reactions caused by anti-IgA.
D000707:Anaphylaxis / Q000209:etiology / Q000517:prevention & control*; D000818:Animals; D000906:Antibodies; D000888:Antibodies, Anti-Idiotypic / Q000032:analysis; D000974:Antibodies, Antinuclear / Q000032:analysis; D001782:Blood Donors; D002417:Cattle / Q000276:immunology; D006041:Goats / Q000276:immunology; D006385:Hemagglutination Inhibition Tests; D006511:Hepatitis B Antigens / Q000032:analysis; D006801:Humans; D017098:IgA Deficiency; D005779:Immunodiffusion; D007070:Immunoglobulin A; D065227:Transfusion Reaction
D000906:Antibodies; D000888:Antibodies, Anti-Idiotypic; D000974:Antibodies, Antinuclear; D006511:Hepatitis B Antigens; D007070:Immunoglobulin A