Coexistence of autoantibodies and alloantibodies to red blood cells due to blood transfusion.
BACKGROUND
Autoantibodies (AUTO) to red blood cells (RBCs) are frequently associated with alloantibodies (ALLO). The mechanism for the coexistence of these antibodies is obscure.


METHODS
Between August 1998 and June 2006, all in- and outpatients of the Charité University Hospital, Berlin, with detectable AUTO were included in this study. Serologic examination was performed with standard techniques for the detection of RBC antibodies.


RESULTS
A total of 717 patients were found to have AUTO, with ALLO observed in 200 of these patients (28%). The history of antibody production could be evaluated in 98 of the 200 patients. Both AUTO and ALLO were due to RBC transfusion in 73 cases (75%) and peripheral blood progenitor cell transplantation in 6 cases (6%). Nine (9%) patients were primarily alloimmunized and subsequently developed AUTO. The remaining 10 (10%) patients were primarily autoimmunized and later developed ALLO. Only 6 of these patients had chronic idiopathic autoimmune hemolytic anemia.


CONCLUSIONS
The majority of AUTO associated with ALLO appears to be due to RBC transfusion that must be recognized as a major cause for autoimmunization.
Ahrens
Norbert
N
Institute for Transfusion Medicine, Charité-University Medicine, Berlin, Germany.
Pruss
Axel
A
Kähne
Andreas
A
Kiesewetter
Holger
H
Salama
Abdulgabar
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000097:blood*; D001604:Berlin; D001803:Blood Transfusion / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D004912:Erythrocytes / Q000276:immunology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007518:Isoantibodies / Q000097:blood*; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D065227:Transfusion Reaction
D001323:Autoantibodies; D007518:Isoantibodies