Unexpected Crossmatch-Incompatible Results by Anti-D in Intravenous Immune Globulin.
- Author:
Jae Woo SONG
1
;
Jung Shin LEE
;
Jeong Won SHIN
;
Hyun Ok KIM
Author Information
1. Department of Clinical Pathology, Yonsei University College of Medicine, Seoul, Korea.
- Publication Type:Case Report
- MeSH:
Antibodies;
Child;
Child, Preschool;
Female;
Hemolysis;
Humans;
Immunoglobulins;
Immunoglobulins, Intravenous*;
Isoantibodies;
Korea;
Male;
Mucocutaneous Lymph Node Syndrome;
Status Epilepticus
- From:Korean Journal of Blood Transfusion
1999;10(2):239-243
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
A number of case report revealed the anti-D reactivity of intravenous immunoglobulin (IVIG). Passive transfer of anti-D activity through administration of IVIG has been implicated as cause of hemolysis in some reports. We have recently identified anti-D and anti-K in two pediatric patients with IVIG (Green corss, Korea) administration history whose red cells were both typed as D positive. One of them was 7 year old male and admitted for status epilepticus. and the other was 2 year old female with impression of Kawasaki disease. The anti-D in D positive patients and anti-K which is one of the least expected red cell alloantibodies considering the phenotypic profile of Kell group antigen in Korea were both thought to be passively transferred with IVIG. Eluate prepared from one of the two patients and diluted IVIG were test for the presence of irregular antibodies. Both tests revealed anti-D activity but not anti-K activity. Passive transfer of anti-D activity through administration of IVIG also has been implicated in hemolysis in some reports with suggestion to set an acceptable limit of anti-D titer for commercial IVIG preparations. The important aspects are what should be the appropriate specification for anti-D titer and what procedures used to measure the anti-D titer of the concentrated pure immunoglobulin preparations like IVIG products.
