Haemolysis induced by intravenously-administered immunoglobulin.
Two concurrent cases of haemolysis that was induced by intravenously-administered gamma-globulin are reported. Haemolysis, predominantly as a result of passively-acquired anti-A antibodies, occurred twice in one patient; anti-D antibodies also were incriminated in the first haemolytic episode. Passively-acquired anti-D antibodies that were found in the same batch of gamma-globulin contributed to the haemolytic episode in the second patient. These adverse reactions could have been prevented if a minor crossmatch procedure had been performed before the commencement of intravenous gamma-globulin therapy. It is considered important that manufacturers of intravenously-administered gamma-globulin preparations decide safe titres of these alloantibodies, and that suitable volumes be dispatched with each batch to enable a minor crossmatch procedure to be performed.
Nicholls
M D
MD
Haematology Department, Repatriation General Hospital Concord, NSW.
Cummins
J C
JC
Davies
V J
VJ
Greenwood
J K
JK
D000328:Adult; D000888:Antibodies, Anti-Idiotypic / Q000032:analysis; D005260:Female; D006461:Hemolysis; D006801:Humans; D007116:Immunization, Passive; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D011696:Purpura, Thrombocytopenic / Q000276:immunology / Q000628:therapy; D005719:gamma-Globulins / Q000008:administration & dosage*
D000888:Antibodies, Anti-Idiotypic; D005719:gamma-Globulins