title: Histological diagnosis of amniotic fluid embolism by monoclonal antibody TKH-2 that recognizes NeuAc alpha 2-6GalNAc epitope.
abstract: This study evaluates whether immunohistochemical staining using antibody TKH-2 is presented as a sensitive method for the histological diagnosis of amniotic fluid embolism (AFE). TKH-2 is the sensitive antibody clearly directed to sialyl Tn, NeuAc alpha 2-6GalNAc and reacts with meconium- and amniotic fluid-derived mucin-type glycoprotein. Formalin-fixed, paraffin-embedded maternal lung tissue sections were obtained from four cases of patients showing AFE, and four women uninvolved with AFE served as control. Specimens were stained using the streptavidin-biotin-immunoperoxidase method. The results of immunostaining were compared with those of hematoxylin-eosin (H&E) or a conventional Alcian blue stain. Remarkable positive TKH-2 stainings were observed easily within the pulmonary vasculature in patients with AFE syndrome. AFE can be easily missed on H&E sections. Compared with TKH-2 staining, Alcian blue staining also may be insufficient to show intravascular mucin in the maternal lung sections. TKH-2 immunostaining is the sensitive method to detect meconium- and amniotic fluid-derived mucin in the lung sections of patients with AFE syndrome.
authors.affiliation: Department of Obstetrics and Gynecology, Hamamatsu University School of Medicine, Shizuoka, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Kobayashi
authors.forename: H
authors.initials: H
authors.lastname: Ooi
authors.forename: H
authors.initials: H
authors.lastname: Hayakawa
authors.forename: T
authors.initials: T
authors.lastname: Arai
authors.forename: Y
authors.initials: Y
authors.lastname: Matsuda
authors.forename: K
authors.initials: K
authors.lastname: Gotoh
authors.forename: T
authors.initials: T
authors.lastname: Tarao
mesh_terms: D000328:Adult; D015295:Antigens, Tumor-Associated, Carbohydrate / Q000032:analysis*; D004619:Embolism, Amniotic Fluid / Q000473:pathology*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007413:Intestinal Mucosa / Q000737:chemistry; D008168:Lung / Q000098:blood supply / Q000737:chemistry*; D011247:Pregnancy
chemical_list: D015295:Antigens, Tumor-Associated, Carbohydrate; C055491:sialosyl-Tn antigen