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Severe Autoimmune Hemolytic Anemia Associated with IgM Warm Autoantibodies Directed against Determinants on or Associated with Glycophorin A
Author(s) -
Garratty G.,
Arndt P.,
Domen R.,
Clarke A.,
SutphenShaw D.,
Clear J.,
Groncy P.
Publication year - 1997
Publication title -
vox sanguinis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.68
H-Index - 83
eISSN - 1423-0410
pISSN - 0042-9007
DOI - 10.1046/j.1423-0410.1997.7220124.x
Subject(s) - autoantibody , autoimmune hemolytic anemia , hemolysis , immunology , hemolytic anemia , medicine , serology , coombs test , anemia , cold agglutinin , antibody
Background and objectives: Autoimmune hemolytic anemia (AIHA) is rarely caused by IgM warm autoantibodies, and is sometimes difficult to diagnose. We describe three patients with severe AIHA caused by IgM warm autoantibodies; in two of the three, the hemolysis was fatal. Materials and methods: Conventional hematologic and serologic procedures were used. Results: The IgM autoantibodies in all three cases were directed against determinants on or associated with glycophorin A (En a , Wr b , and Pr). The IgM autoantibodies had unusual serological characteristics, in that the agglutinins were detected or greatly enhanced only by the presence of albumin or a low pH, and/or the agglutinins reacted optimally at 20–30°C. Conclusions: IgM warm autoantibodies directed at determinants on or associated with glycophorin A appear to cause severe (often fatal) hemolytic anemia.