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A Case Report of Anti-Jr(a) in Pregnant Woman.

Hyun Kyong KIM ; Quehn PARK ; Chung Hyun NAHM ; Oh Hun KWON ; Yong Won PARK

Korean Journal of Blood Transfusion.1995;6(2):185-188.

The high incidence antigert Jr" was first identified in 1970 by Stroup and Macllroy. Anti-Jr~ was immune antibodies developed by transfusion or pregnancy and occasionally cause hemolytic disease of the newborn and transfusion reaction, but these usually mild. We are reporting the first case of anti-Jra in Korea, which was identified in pregnant woman with transfusion history. The 35 year old pregnant woman(G6P4L1D3A1) admitted to treat for incompetent internal os of cervix on department of Obstetrics and Gynecology. Prenatal irregular antibody screening was negative. One unit of RBC was transfused at 21 gestational weeks for correction of anemia. One week later, irregular antibody was detected in her serum. The antibody reacted best by indirect antiglobulin test and panagglutinated all identified cells. The titer was 1 : 8. The antibody was identified as anti-Jr by Dr. Osaka Red Cross Center. Her phenotype of Jra was Jr(a-), but there was no Jr(a-) person in her family. She might have anti-Jra in her serum with undetectable level due to multiple pregnancies. In this case, the development of anti-Jr was stimulated by one unit of RBC transfusion with anamnestic reaction. The titer of anti-Jr was gradually reduced during pregnant period. She delivered at 37 gestational weeks by cesarian section. The baby was clinically well at birth and typed as Jr(a+).
Adult ; Anemia ; Antibodies ; Blood Group Incompatibility ; Cervix Uteri ; Coombs Test ; Female ; Gynecology ; Humans ; Incidence ; Infant, Newborn ; Korea ; Mass Screening ; Obstetrics ; Parturition ; Phenotype ; Pregnancy ; Pregnancy, Multiple ; Pregnant Women* ; Red Cross

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Cryopathic Hemolytic Anemia: A case report.

Jong Weon CHOI ; Jin Tae SUH ; Mi Kyung LEE

Korean Journal of Blood Transfusion.1995;6(2):177-184.

The cryopathic hemolytic anemia is an autoimmune hemolytic anemia induced by cold antibody. Authors report a case of cryopathic hemolytic anemia confirmed by immunohematologic examination. A 22-year-old man was admitted at Kyung Hee Medical Center in March, 1994, with a past history of Kleinerfelter's syndrome and complained jaundice as well as dizziness. Direct antiglobulin test using polyvalent and anti-C3d monovalent antisera was positive, but was negative against anti-IgG, anti-IgA, and anti-IgM monovalent antisera. Cold agglutinin titer was as high as 1:1024 at 4 degrees C and anti-I specificity was confirmed by using cord bloods. The patient was not improved despite transfusion of washed red cells and administration of prednisolone, and on 16th day of hospitalization he manifested sudden episode of headache and loss of conscioussness, soon followed by death.
Anemia, Hemolytic* ; Anemia, Hemolytic, Autoimmune ; Coombs Test ; Dizziness ; Fetal Blood ; Headache ; Hospitalization ; Humans ; Immune Sera ; Jaundice ; Prednisolone ; Sensitivity and Specificity ; Young Adult

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Stem Cell Supportive Care in Chemotherapy of Acute Leukemia.

Jang Soo SUH ; Sun Kun BAE ; Jae Tae LEE ; Kyu Bo LEE ; Sang Kyun SOHN ; Kyung Hye LEE ; Kun Soo LEE

Korean Journal of Blood Transfusion.1995;6(2):169-176.

OBJECT: Peripheral blood stem cells(PBSC) were collected after remission induction chemotherapy and reinfused after intensified chemotherapy in order to increase the chemotherapeutic efficacy. METHOD: Collection of mononuclear cells(MNC) was started when CD34+ cells above 1% and WBC above 1,000/ul with mononuclear cell percentage above 30%, the collection procedures were done 2-6 times in each patient of total 6 cases. The collected MNCs were stored in -75 degrees C and reinfused after thawing in the water bath at 37 degrees C. RESULTS: Twenty three collection procedures from the 6 cases of acute leukemia had made effective MNC collection in 4 cases and mean collection efficiency was 49.8%(from 39.0% to 74.5%). Hematological changes after the procedure were mean reduction of hemoglobin 1.34g/dl and mean 20.25% of decreased platelet count. There were noticed transient symptoms of discomfort, coughing, chest tightness and dyspnea in association with the infusion of stored cells. CONCLUSION: The basic process for the peripheral blood stem cell transplantation(PBSCT) was accomplished with this supportive care for the consolidation chemotherapy of acute leukemia. Effective PBSCT would be warrented with more qualified process and high dose chemotherapy.
Baths ; Consolidation Chemotherapy ; Cough ; Drug Therapy* ; Dyspnea ; Humans ; Leukemia* ; Platelet Count ; Remission Induction ; Stem Cells* ; Thorax ; Water

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Experience of the Use of Three Screening Kits, Enzygnost Anti-HIV1/2 Plus, ABBOTT TESTPACK HIV- 1/HIV-2 & SERODIA. HIV- 1/2 for the Detection of Antibodies to HIV.

Gyoung Yim HA ; Eun Ha KOH ; Moon Youn KIM

Korean Journal of Blood Transfusion.1995;6(2):161-168.

We compared the performance of three screening kits for the detection of anti-HIV in 187 samples; Enzygnost Anti-HIV 1/2 Plus, ABBOTT TESTPACK HIV- 1/HIV-2 & SERODIA. HIV- 1/2. Four samples, 3 serums and 1 CSF, from 2 patients were repeatedly reactive in all three screening kits and 2 serum specimens were confirmed positive(HIV-1) by the western blot assay. The sensitivity and specificity of all three screening kits were 100% and 98.9%, respectively. In Korea, the cause of AIDS is mostly HIV-1 and the prevalence is very low. So, all three screening kits were useful for the detection of anti-HIV from patients and blood donors. But the use of screening kit for the detection of anti-HIV-1, anti-HIV-2 and anti-HIV-I subtype O will be needed for the decrement of false negative rate because HIV infection has been increased, especially, HIV-2 infection and pediatric AIDS patient by vertical transmission were also reported, currently.
Antibodies* ; Blood Donors ; Blotting, Western ; HIV Infections ; HIV* ; HIV-1 ; HIV-2 ; Humans ; Korea ; Mass Screening* ; Prevalence ; Sensitivity and Specificity

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Evaluation of the Status of Frozen Thawed Platelet Concentrations By using 6% Dimethyl Sulfoxide Cryopreservation method.

Jun Suk KIM ; Byung Soo KIM ; Kap No LEE ; Chae Seung LIM ; Young Kee KIM

Korean Journal of Blood Transfusion.1995;6(2):155-160.

We tried to analyze the status of 10 units of frozen thawed apheresis platelet concentration by 6% DMSO method for the evaluation of practical applicability. The platelet concentrations were transferred to PL-732(Baxter, USA) cryopreservation bag, and DMSO is added to those bag at slow rate until expected final 6% concentration is achieved, thereafter those were directly placed to -80 degrees C refrigerator for freezing. Someday later from I week to 1 month, those were thawed at 37 degrees C water bath, and then washed by same volume of ABO matched plasma. In the course of cryopreservation, about 7% of platelets were lost and the mean recovery rate of platelet was 93% compared with those of unfrozen status. LDH, the values of platelet lysis, and pH were within normal limits, whereas platelet aggregation test shows decreased aggregation to collagen and ristocetine compared with those of unfrozen status(p<0.05) but they were clinically acceptable. We suggest that the frozen platelets may be useful in a some clinical situation such as hematologic malignancy and solid tumor by autologous transfusion.
Baths ; Blood Component Removal ; Blood Platelets* ; Collagen ; Cryopreservation* ; Dimethyl Sulfoxide* ; Freezing ; Hematologic Neoplasms ; Hydrogen-Ion Concentration ; Plasma ; Platelet Aggregation ; Ristocetin ; Water

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Changes of Plasma Components by the Plasma Exchange.

Hyo Jin CHUN ; Jae Ryong KIM ; Gyoung Yim HA ; Dong Seok JEON ; Dal Hyo SONG

Korean Journal of Blood Transfusion.1995;6(2):141-154.

Therapeutic plasma exchange is used in almost every condition in which there is a plasma factor thought possibly to the etiology or pathogenesis of a disease or one of its manifestations. In order to evaluate plasma exchange using fresh frozen plasma as replacement solution, eighty four therapeutic plasma exchanges were carried out in eighteen patients. In standardized procedures, 1.5 times the calculated plasma volume was replaced with a Hartman's solution and fresh frozen plasma. Anticoagulation was achieved using a whole venous blood to 2.5% trisodium citrate in the ratio of 10 to 1. Total calcium, phosphorus, glucose, urea nitrogen, creatinine, bilirubin, alkaline phosphatase, amylase, creatine kinase, IgG, C3, total white and red blood cell count, hemoglobin, and differential count were not significantly affected by the procedure. In contrast, serum cholesterol, total protein, albumin, aspartate aminotransferase, alanine aminotransferase, ionized calcium, IgM, C4 and platelet were significantly decreased by the plasma exchange. All these measurements had returned to the first pre-exchange level within 24 hours, while the C4 and platelet count took between 24 and 72 hours, and the IgM level, between 72 hours and 1 week. These data indicated that in an isovolemic plasma exchange there was a transient but rapidly reversible effect on all the components studied, with C4 and platelet count, returning more slowly to pre-exchange level than the others, and IgM levels responding the slowest. In summary, plasma exchanges using fresh frozen plasma as replacement solution were assumed to be not significantly affected the function of various organs.
Alanine Transaminase ; Alkaline Phosphatase ; Amylases ; Aspartate Aminotransferases ; Bilirubin ; Blood Platelets ; Calcium ; Cholesterol ; Citric Acid ; Creatine Kinase ; Creatinine ; Erythrocyte Count ; Glucose ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Nitrogen ; Phosphorus ; Plasma Exchange* ; Plasma Volume ; Plasma* ; Platelet Count ; Urea

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Clinical Experience of Plasma Exchange.

Kyung Hye LEE ; Sang Soo SUH

Korean Journal of Blood Transfusion.1995;6(2):131-140.

BACKGROUND: Plasmapheresis or plasma exchange is the procedure to remove various pathogenic materials from the circulation of patients and retransfuse the formed elements into the doners with type specific fresh frozen plasma or albumin for the replacement of the withdrawn plasma. METHODS: In order to evaluate clinical experience of plasma exchange, we examined a total of 133 plasma exchange procedure on 25 patients of January 1993 - May 1994 in Kyungpook national university hospital. RESULTS: The results are as follows: 1. There were 8 kinds of diseases and the most frequent diseases was Guillian-Barre syndrome(l 2 cases) and the decreasing order was CIDP(6 cases), multiple myeloma(2 cases), acute fulminant hepatitis(1 case), mushroom poisoning(1 case), lupus nephritis(l case), TTP(I case) and myasthenia gravis(l case). 2. The patient's age ranged from 13 to 65 years. 3. There were 14 males and 11 females and the sex ratio was 1.3:1. 4. We had got clinical improvement in 16 of 25 cases, especially most dramatic effect in Guillian-Barre syndrome. CONCLUSION: To achieve more successful outcome of plasma exchange, we should select patients with restrict application, prevent rebound phenomenon with intense practice, choose what kind of replacement fluid to consider patient's clinical condition and check serological parameter with clinical evaluation to monitor effectiveness of treatment.
Agaricales ; Female ; Gyeongsangbuk-do ; Humans ; Male ; Plasma Exchange* ; Plasma* ; Plasmapheresis ; Sex Ratio

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Detection of Platelet-Specific Antibodies Employing Modified Antigen Capture ELISA(MACE).

Tae Hyun UM ; Kyou Sup HAN ; Dae Chul KIM ; Yoo Sung HWANG ; Doo Sung KIM ; Sang In KIM

Korean Journal of Blood Transfusion.1995;6(2):123-130.

Widely used tests for the detection of platelet antibodies in Korea include platelet suspension immunofluorescence test(PSIFT), enzyme immunoassay and mixed passive hemagglutination(MPHA). In these tests, removal of HLA antigens from platelet are required to detect platelet-specific antibodies. Modified antigen capture ELISA(MACE) is known to be very sensitive for the detection of platelet-specific antibodies, in which specific platelet glycoprotein, captured by the monoclonal antibody is used as a target antigen. MACE is very useful for the detection of platelet-specific alloantibodies in neonatal alloimmune thrombocytopenia(NAIT) and posttransfusion purpura(PTP). We employed MACE in our laboratory, using AP2(anti-GPIIb/IIIa, monoclonal), #30 sera(anti-PlA1), 90-545 sera(anti-HLA-B51+52) and LYS sera(multispecific HLA antibodies). LYS sera had been used as our positive control( 1:120) in MPHA. Platelet from PIA1(+), HLA-B5 I, blood group O healthy male donor, gave positive result with #30 sera(1:40) and negative result with 90-545 sera in MACE. With LYS sera, MACE showed negative in 1:120, but positive in 1:20. So LYS sera was thought to contain strong multispecific HLA antibodies and relatively weak antibody(-ies) reacting with GPllb/Illa. Further studies employing different monoclonal antibodies, such as anti-GPIb/IX, -GPIa/Ila and -GPIV are under way.
Antibodies* ; Antibodies, Monoclonal ; Blood Platelets ; Fluorescent Antibody Technique ; Glycoproteins ; HLA Antigens ; Humans ; Immunoenzyme Techniques ; Isoantibodies ; Korea ; Male ; Tissue Donors

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The First Case of Posttransfusion Purpura Caused by anti-HPA-3a Antibody in Korea.

Sang Hoon SONG ; Dong Chan KIM ; Yang Hyun KIM ; Sang Man JIN ; Sung Soo YOON ; Dong Hee SEO ; Myoung Hee PARK ; Kyou Sup HAN

Korean Journal of Blood Transfusion.2005;16(1):56-62.

Posttransfusion purpura is a rare but potentially fatal disorder, characterized by the development of severe thrombocytopenia following transfusion. We report the first case of posttransfusion purpura in Korea in a 39-year-old multiparous woman. Nine days after transfusion of two units of red blood cells during cesarian section operation, she developed sudden onset of purpura, gum bleeding, and severe thrombocytopenia. Serological analysis revealed that the patient had antibodies against HPA-3a (Baka) and HLA. She was treated with plasmapheresis and the platelet count dramatically normalized. Though posttransfusion purpura is a self-limited disorder, early diagnosis and proper treatment can shorten the duration of the clinical course.
Adult ; Antibodies ; Early Diagnosis ; Erythrocytes ; Female ; Gingiva ; Hemorrhage ; Humans ; Korea* ; Plasma Exchange ; Plasmapheresis ; Platelet Count ; Purpura* ; Thrombocytopenia

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First case of Anti-Wra antibody in Korea.

Seong Ho KANG ; Mi Sook YOON ; Dong Chan KIM ; Hee Sung KIM ; Soon Beom KANG ; Kyou Sup HAN

Korean Journal of Blood Transfusion.2005;16(1):52-55.

Authors found anti-Wra antibody in a 44-year-old female patient with uterine myoma for the first time in Korea. Since anti-Wright antibodies have been implicated in hemolytic transfusion reactions and hemolytic disease of the newborn, Wra positive cells should be included in the antibody screening panel in Korea.
Adult ; Antibodies ; Blood Group Incompatibility ; Female ; Humans ; Infant, Newborn ; Korea* ; Leiomyoma ; Mass Screening

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