Red blood cell transfusion refractoriness due to mimicking alloantibodies: a case report
10.13303/j.cjbt.issn.1004-549x.2026.03.014
- VernacularTitle:类同种特异性自身抗体引起红细胞输注无效1例
- Author:
Xiaomei JIE
1
;
Ziyi HE
1
;
Yiming HU
1
;
Menghui BEI
1
;
Yatao FEI
1
Author Information
1. Blood Transfusion Research Laboratory of Dongguan Central Blood Station, Dongguan 523000, China
- Publication Type:Journal Article
- Keywords:
mimicking alloantibodies;
antibody identification;
red blood cell transfusion refractoriness;
enzyme-IAT;
transfusion strategy
- From:
Chinese Journal of Blood Transfusion
2026;39(3):397-401
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To identify the mimicking autoantibodies using papain-enhanced erythrocyte agglutination in a case of repeated red blood cell transfusion refractoriness, aiming to explore the immune hematological methods for identifying mimicking alloantibodies, autoantibodies and alloantibodies, and to develop a safe and effective blood transfusion strategy based on the results. Methods: ABO, RhD and RhEeCc blood groups were detected using routine blood group serological method. The unexpected antibodies in plasma were screened and identified, followed by identification using a two-step papain-treated indirect antiglobulin test (enzyme-IAT). The cause of transfusion refractoriness of red blood cells was analyzed and summarized, and the prognosis was followed up. Results: The patient's blood type was type A, CCDee. The direct antiglobulin test (DAT) was positive. Unexpected antibody screening and identification using saline tube method, polybrene method, IAT were negative, and the release fluid (acid release) IAT identification was negative. Mimicking anti-e antibodies in plasma was identified by enzyme-ITA. The cause of red blood cell transfusion refractoriness in patients was autoimmune hemolysis caused by mimicking anti-e antibodies. After choosing to avoid antibodies corresponding to antigen-positive red blood cells, the patient's hemoglobin (Hb) increase value is in line with theoretical expectations, indicating effective red blood cell transfusion. Conclusion: Mimicking antibodies can cause immune destruction of red blood cells by non-specific binding to their own red blood cells and specific binding to red blood cells, resulting in red blood cell transfusion refractoriness.
