title: Clinical significance of anti-At(a).
abstract: Ata is a high-frequency red blood cell (RBC) antigen. Anti-At(a) has been reported in rare At(a-) black subjects. We report two cases of anti-At(a). A clinically significant anti-At(a) was found in a 26-year-old black woman with systemic lupus erythematosus. The patient had a transfusion reaction with chills and nausea during a RBC survival study, and 95% of the radiolabeled At(a+) RBCs were destroyed within 3 h. A concurrently performed monocyte monolayer assay was strongly reactive. Anti-At(a) thus can cause rapid hemolysis of transfused RBCs, but At(a-) donor units are extremely scarce in rare donor registries. A second patient at our hospital had anti-At(a) which did not affect her newborn. She also had autoimmune disease, insulin-dependent diabetes mellitus.
authors.affiliation: Department of Pathology, Northwestern University Medical School, Chicago, Ill., USA.
authors.forename: G
authors.initials: G
authors.lastname: Ramsey
authors.forename: L A
authors.initials: LA
authors.lastname: Sherman
authors.forename: A M
authors.initials: AM
authors.lastname: Zimmer
authors.forename: W G
authors.initials: WG
authors.lastname: Spies
authors.forename: L
authors.initials: L
authors.lastname: Sharma
authors.forename: P
authors.initials: P
authors.lastname: Arndt
authors.forename: G
authors.initials: G
authors.lastname: Garratty
mesh_terms: D000328:Adult; D001327:Autoimmune Diseases / Q000276:immunology; D044383:Black People / Q000235:genetics; D001789:Blood Group Antigens / Q000235:genetics / Q000276:immunology*; D002641:Chicago; D003922:Diabetes Mellitus, Type 1 / Q000276:immunology; D005260:Female; D006172:Guyana / Q000208:ethnology; D006461:Hemolysis; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology*; D007518:Isoantibodies / Q000276:immunology*; D008145:Louisiana / Q000208:ethnology; D008180:Lupus Erythematosus, Systemic / Q000276:immunology; D008181:Lupus Nephritis / Q000276:immunology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000276:immunology; D065227:Transfusion Reaction; D001741:Black or African American
chemical_list: D001789:Blood Group Antigens; D007074:Immunoglobulin G; D007518:Isoantibodies