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A high‐titer, high‐thermal‐amplitude autoanti‐B associated with acrocyanosis but no obvious hemolytic anemia
Author(s) -
Arndt Patricia A.,
Do Jennifer B.,
Garratty George,
Kuriyan Mercy A.,
Strair Roger K.,
Baranwal Akhil
Publication year - 2003
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1046/j.1537-2995.2003.00453.x
Subject(s) - autoantibody , immunology , hemolytic anemia , titer , medicine , anemia , serology , coombs test , abo blood group system , autoimmune hemolytic anemia , antibody , gastroenterology
BACKGROUND: ABO autoantibodies are rare. Most reported examples have been antibodies with 4°C titers not greater than 256 in patients without apparent hemolytic anemia. Most high‐titer, high‐thermal‐amplitude, complement‐activating cold agglutinins are associated with hemolytic anemia. STUDY DESIGN AND METHODS: A 52‐year‐old man presented with acrocyanosis and mild small‐vessel brain disease, but no evidence of obvious hemolytic anemia. Regular plasmapheresis treatment was helpful in relieving the clinical symptoms associated with acrocyanosis. Serologic methods were used to study the patient's RBCs and sera. RESULTS: The patient's RBCs were strongly reactive with anti‐C3 and anti‐IgM and weakly reactive with anti‐IgA. The patient's serum contained a high‐titer, high‐thermal‐amplitude, IgMκ autoanti‐B, capable of activating complement in vitro. CONCLUSION: A patient with a powerful ABO autoantibody is described. This patient had acrocyanosis but did not appear to have an obvious hemolytic anemia. This case is a good example of the lack of correlation between in vitro serologic tests and in vivo reactions in individual patients.