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Autoagglutination Developing in a Patient with Acute Renal Failure
Author(s) -
Dorner Irene M.,
Parker Charles W.,
Chaplin Hugh
Publication year - 1968
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.1968.tb06990.x
Subject(s) - in vivo , albumin , elution , chemistry , abo blood group system , medicine , chromatography , biology , microbiology and biotechnology
S ummary . A patient with post‐traumatic renal failure (presumably renal cortical necrosis) is described, who developed near the end of his course a potent auto‐agglutinin (titre 1024 at 37° C.). A unique feature of the autoagglutinin was its elution into serum or 8 per cent albumin solution, but its failure to elute into saline under standard conditions. The importance of this phenomenon in permitting accurate ABO and Rh grouping of the patient's cells is emphasized. Studies of the patient's serum, including DEAE fractionation, reduction and alkylation, and absorption with anti‐γ, serum, indicated that the autoagglutinin was a γ M globulin. The relationship of these techniques to tests for coexisting isoanti‐bodies and to safe cross‐matching procedures is discussed. The results of in‐vivo cross‐matching procedures ( 51 Cr labelling and haem pigment changes) are described and their role in enhancing the safety of transfusion in the face of inconclusive in‐vitro cross‐matching is stressed.