Relation of haemolytic anaemia and erythrocyte-bound IgG in alpha- and beta-thalassaemic syndromes.
There has been evidence that IgG-mediated phagocytosis plays some part in destruction of erythroid cells and subsequent anaemia in thalassaemia. In this study using direct immunofluorescence and flow cytometry, erythrocyte-bound IgG was studied in 53 and 33 beta-thal/Hb E and Hb H patients, respectively. The mean percentages of IgG-positive erythrocytes in both nonsplenectomized (4.4%) and splenectomized (24%) beta-thal/Hb E patients were significantly higher than that in normal subjects (1.0%); p < 0.05 and < 0.001, respectively. Splenectomized beta-thal/Hb E patients had significantly higher percentages of IgG-positive erythrocytes than the nonsplenectomized patients (p < 0.001). The mean percentages of IgG-positive erythrocytes in Hb H patients were comparable to those from normal controls. However, patients with alpha-thal 1/Hb CS had significantly higher IgG-positive erythrocytes than those with alpha-thal 1/alpha-thal 2 (p = 0.008). Splenectomized Hb H patients also had higher IgG-positive erythrocytes than nonsplenectomized Hb H patients (p < 0.039). During haemolytic crisis in some Hb H patients, high percentages of IgG-positive erythrocytes were also demonstrated. This study demonstrates the presence of increased IgG on erythrocytes in patients with beta-thal/Hb E and in those with Hb H disease following splenectomy or in haemolytic crisis.
Chinprasertsuk
S
S
Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Wanachiwanawin
W
W
Pattanapanyasat
K
K
Tatsumi
N
N
Piankijagum
A
A
D000328:Adult; D000743:Anemia, Hemolytic / Q000097:blood / Q000209:etiology* / Q000276:immunology; D004912:Erythrocytes / Q000276:immunology*; D005260:Female; D005838:Genotype; D006446:Hemoglobin E / Q000032:analysis; D006447:Hemoglobin H / Q000032:analysis; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D013156:Splenectomy; D017085:alpha-Thalassemia / Q000097:blood / Q000150:complications* / Q000276:immunology; D017086:beta-Thalassemia / Q000097:blood / Q000150:complications* / Q000276:immunology
D007074:Immunoglobulin G; D006446:Hemoglobin E; D006447:Hemoglobin H