RESUMO
Objetivo: Analizar lavalidación de la detección de anticuerpos irregulares (PAI) mediante el uso del reactivo de control de Coombs en muestras de sangre tomadas de Febrero 2015 a Agosto 2016. Métodos: Estudio de naturaleza observacional, retrospectivo y prospectivo, con los procedimientos técnicos de carácter documental, que se sucederá em Laboratorio de Inmunohematología del Hemocentro Regional de Montes Claros - MG. Resultados: Se observó durante la encuesta que después de la no validación de algunos testes y sucedida la repetición del mismos individuos, no se ha encontrado la validación, por lo tanto requeiendo otra repetición hasta que la validación de la muestra. Esto plantea la posibilidad de interferencia que no sea el conocido y discutido, ya que la repetición se realiza aisladamente el análisis crítico de todos los pasos del proceso. Conclusión: El bajo porcentaje de resultados no validados ratifica la prueba de validación antiglobulínico es un buen método para confirmar el resultado de la búsqueda de anticuerpos irregulares
Objetivo: Analisar a validação da pesquisa de anticorpos irregulares (PAI) através da utilização do reagente Controle de Coombs em amostras sanguíneas coletadas de Fevereiro de 2015 à Agosto de 2016. Métodos: Estudo de natureza observacional, retrospectiva e prospectiva, apresentando procedimentos técnicos de caráter documental, a ser realizado no Laboratório de Imunohematologia do Hemocentro Regional de Montes Claros - MG. Resultados: Foi observado durante a pesquisa que após a não validação de alguns testes e realizada a repetição dos mesmos isoladamente, não foi constatado a validação sendo necessário outra repetição até que essa amostra validasse. Esse fato levanta a possibilidade de outras interferências além das conhecidas e discutidas, uma vez que a repetição foi realizada isoladamente analisando criticamente todas as etapas do processo. Conclusão: O baixo percentual de resultados não validados ratifica que o teste de validação antiglobulínico é um bom método para confirmar o resultado da pesquisa de anticorpos irregulares
Objective: The study's purpose has been to assess the validation of irregular antibodies investigation using the Coombs control reagent in blood samples collected over the period from February 2015 to August 2016. Methods: It is a observational, retrospective and prospective study, which presents technical procedures bearing a documentary character, and that was performed at the Laboratory of Immunohematology from the Regional Blood Center in Montes Claros-MG. Results: During the research, it was observed that after the non-validation of some tests and its repetition was then performed alone; the validation was not verified and once again a repetition was necessary until this sample was defined as validated. This fact raises the possibility of other interferences beyond those both known and discussed; bearing in mind that the repetition was carried out in isolation and also all stages of the process were performed under scrutiny. Conclusion: The low percentage of non-validated results ratifies that the antiglobulin validation test is a good method to confirm the result of the search for irregular antibodies
Assuntos
Humanos , Masculino , Feminino , Doadores de Sangue , Teste de Coombs/instrumentação , Teste de Coombs/métodos , Serviço de HemoterapiaRESUMO
Introducción: la importancia de los grupos sanguíneos para la terapia transfusional y el trasplante es bien conocida. La presencia de anticuerpos eritrocitarios puede mediar reacciones transfusionales hemolíticas severas y rechazo de trasplante. Objetivo: caracterizar los antígenos y anticuerpos eritrocitarios en pacientes en espera de trasplante renal.Métodos: se realizó un estudio prospectivo en 980 pacientes en espera de trasplante renal considerados aptos para trasplante, en el periodo comprendido entre julio de 2013 y julio de 2014. Se investigó la frecuencia de los grupos sanguíneos ABO, Rh (DCcEe), Kell (K), Duffy, Kidd y Lewis y se realizó la pesquisa de auto y de aloanticuerpos eritrocitarios a través de las prueba de antiglobulina directa e indirecta (Coombs) y la técnica de polietilenglicol. Resultados : el grupo sanguineo 0 fue el más frecuente, seguido del A, el B y el AB. Dentro de los fenotipos RhD positivos, el DCCee predominó en los individuos blancos y el Dccee en los no blancos. El RhD negativo (ccee) fue más frecuente en blancos que en no blancos. La distribucion del antigeno Kell fue similar en ambos grupos. Se identificaron 14 pacientes (1,4 por ciento) con prueba de Coombs directa positiva, y aloanticuerpos eritrocitarios en 35 pacientes, para una frecuencia de aloinmunización eritrocitaria del 3,6 por ciento. Predominaron los anticuerpos anti - Rh y contra el antigeno Kell. La técnica de polietilenglicol detectó un mayor número de anticuerpos que la PAI, especialmente contra el antigeno RhD, aunque la comparación no fue estadisticamente significatica. Conclusiones: la frecuencia de aloinmunización eritrocitaria es menor que las comunicadas en otros estudios y se relacionó con los antecedentes transfusionales. Se recomienda realizar la pesquisa de auto y aloanticuerpos eritrocitarios a todos los pacientes con enfermedad renal crónica en lista de espera de trasplante(AU)
Introduction: The importance of blood groups in transfusion therapy and transplant is very well known. The presence of red blood cell antibodies can mediate severe hemolytic transfusion reactions and transplant rejection. Objective: To characterize red blood cell antigens and antibodies in patients awaiting renal transplantation. Methods: A prospective study in 980 patients in waiting list for renal transplantation in the period from July, 2013 to July, 2014 was carried out. The frequency of ABO, Rh (DCcEe), Kell (K), Duffy, Kidd and Lewis blood groups, and the screening of red blood cells auto and alloantibodies by the direct and indirect antiglobulin test (Coombs) and the polietilenglicol technique were investigated. Results: Blood group O was the most frequent followed by A, B and AB. DCCee phenotype was frequent in white individuals and Dccee in non-white. RhD negative (ccee) was more frequent in whites than in non-whites. Distribution of Kell antigen was similar in both groups. Direct antiglobulin test was positive In 14 patients (1,4 percent) and red blood cell alloantibodies were identified in 35 patients for a frequency of alloimmunization of 3,6 percent. Anti-Rh anti-K antibodies were the alloantibodies most frequently identified. The polietilenglicol technique detected a higher number of antibodies than the indirect antiglobulin test, specially against RhD antigen, although the comparison was not statistically significant. Conclusions: The frequency of alloimmunization is smaller than those communicated in other studies which was related to transfusion records. A periodic red blood cell auto and alloantibodies screening is recommended in all patients awaiting renal transplantation(AU)
Assuntos
Humanos , Transplante de Rim/métodos , Transfusão de Eritrócitos/métodos , Antígenos de Grupos Sanguíneos/efeitos adversos , Teste de Coombs/métodos , Estudos Prospectivos , AnticorposRESUMO
BACKGROUND: Difficulties with the direct antiglobulin test (DAT) and its apparent lack of sensitivity and specificity for immune-mediated hemolytic anemia (IMHA) in dogs have raised skepticism regarding its diagnostic value. OBJECTIVE: To compare different DATs and other hematologic parameters in dogs. ANIMALS: Anticoagulated blood samples from 59 nonanemic and 46 anemic dogs (± IMHA) from a research colony and veterinary clinics. METHODS: Prospective observational study: Immunochromatographic strip, gel microcolumn, and capillary techniques were compared with standard microtiter DAT using 2 polyvalent antiglobulins. Spherocytosis, autoagglutination, osmotic fragility, and clinical data were assessed. RESULTS: Blood samples from all 59 nonanemic dogs were DAT-. Among 46 anemic dogs, 33 were suspected of IMHA, but only 20 were DAT+. Old and new DAT methods yielded comparable and consistent results even after storage of chilled blood samples for 1 week. Spherocytosis and autoagglutination (that did not persist after washing) were noted in 15 and 16 DAT+ dogs, respectively. The other 26 anemic dogs, including 21 previously transfused dogs and 4 with autoagglutination, tested DAT- by the other methods. Osmotic fragility was increased in 70% (19/27) of anemic and all 15 DAT+ dogs tested. Limited follow-up testing revealed DAT+ results for 3-70 days. CONCLUSIONS AND CLINICAL IMPORTANCE: The novel strip and capillary DAT methods are promising adjunct in-clinic tools. Despite prior immunosuppressive treatment and presence of autoagglutination, the DAT was positive in anemic dogs with IMHA. Transfusion did not cause false DAT+ results. Our results support DAT as a cornerstone in the diagnosis of canine IMHA.
Assuntos
Anemia Hemolítica Autoimune/veterinária , Teste de Coombs/veterinária , Doenças do Cão/diagnóstico , Anemia Hemolítica Autoimune/diagnóstico , Anemia Hemolítica Autoimune/imunologia , Animais , Anquirinas/deficiência , Anquirinas/imunologia , Anticorpos Anti-Idiotípicos/imunologia , Teste de Coombs/métodos , Doenças do Cão/imunologia , Cães , Feminino , Masculino , Sensibilidade e Especificidade , Esferocitose Hereditária/diagnóstico , Esferocitose Hereditária/imunologia , Esferocitose Hereditária/veterináriaRESUMO
Se obtuvo suero antiglobulínico (Coombs) con el empleo de un inóculo consistente en un inmunocomplejo (IC) inmunoglobulina (Ig) humana-antiglobulina humana en carnero, como opsonina para favorecer la respuesta inmune. Se inmunizaron 18 carneros divididos en 3 grupos de 6: el primero y el segundo destinados a producir anti-IgG y anti-C3, respectivamente. Estos, a su vez, subdivididos en subgrupo A: en el que se empleó el método tradicional de obtención de suero de Coombs; y B: en el que se usó el adyuvante completo de Freud en la dosis inicial y el IC en la fase de mantenimiento. Al tercer grupo solo se le administró el IC puro (subgrupo A) y en una dilución 1:200 (subgrupo B). En los carneros de los subgrupos 1B y 2B se obtuvieron títulos más elevados de anti-IgG y anti-C3dg, que en los inmunizados por el método tradicional. La respuesta de anticuerpos en los animales que se inmunizaron con los IC (3A y 3B), fue más rápida y de mayor título que las obtenidas por el método tradicional (1A y 2A) o el método combinado (1B y 2B). La respuesta en el subgrupo 3B fue más prolongada, al parecer por un efecto de dosis
An antiglobulin serum (Coombs) was obtained using a consistent inoculums in a immunocomplex (IC) the human immunoglobulin (Ig)/human antiglobulin in the seep by example, the opsonin to favor the immune response. Eighteen sheeps were immunized divided into three groups of 6 each: The first and second aimed to produce anti-IgG and anti-C3, respectively. In turn, these were divided into the A subgroup: in which we used the traditional method of Coombs's serum obtaining and B group in which we used the Freud's whole adjuvant in initial dose and the IC in the maintaining phase. Third group received the pure IC (A subgroup) and at a dilution of 1:200 (B subgroup). In sheeps from the 1B and 2B subgroups it was possible to obtain higher titration of anti-IgG and anti-C3dg than those immunized by means of the traditional method. The antibody response in animals immunized with the ICs (3A and 3B) was faster and of higher titration than those obtained by traditional method (1A and 2A) or the combined method (1B and 2B). The response in the 3B subgroup was lengthier apparently by a dose effect
Assuntos
Animais , Adjuvante de Freund , Imunoglobulinas , Proteínas Opsonizantes/imunologia , Teste de Coombs/métodos , Soros Imunes , Ovinos/imunologia , Ovinos/sangueRESUMO
Las anemias hemolíticas autoinmunitarias se caracterizan por la presencia de inmunoglobulinas en la superficie eritrocitaria dirigidas contra los determinantes antigénicos de los hematíes. La anemia hemolítica autoinmune por anticuerpos calientes se caracteriza porque los autoanticuerpos actúan a la temperatura del organismo (37°C), son de clase IgG y la hemólisis es predominantemente extravascular, siendo el tipo más frecuente de anemia hemolítica autoinmune en los niños de 2-12 años de edad. Sus manifestaciones clínicas son postración, palidez, ictericia, fiebre y hemoglobinuria. El diagnóstico de las AHAI se establece con la prueba de Coombs. La administración de corticoesteroides constituye el tratamiento inicial de elección. Se presenta el caso de una preescolar femenina de tres años de edad procedente del medio rural, quien exhibe las características clínicas, paraclínica y epidemiológicas de anemia hemolítica autoinmune por anticuerpos calientes, con respuesta satisfactoria a la terapia con esteroides.
Assuntos
Humanos , Feminino , Pré-Escolar , Anemia Hemolítica Autoimune/classificação , Anemia Hemolítica Autoimune/diagnóstico , Anemia Hemolítica Autoimune/patologia , Anorexia/diagnóstico , Anticorpos/efeitos adversos , Icterícia/diagnóstico , Imunoglobulina G/uso terapêutico , Imunoglobulinas/análise , Palidez/diagnóstico , Teste de Coombs/métodos , Bilirrubina/imunologia , Leucemia Linfoide/sangue , Pediatria , Transfusão de Eritrócitos/métodosRESUMO
Drugs can result in broad variety of hematologic abnormalities including positive direct antiglobulin test. In this study, we evaluated gel microcolumn assay for the detection of drug-induced antibodies. Direct antiglobulin test was performed by conventional tube and by gel microcolumn assay in 139 hospitalized patients. Drug in vitro studies were done in 34 patients with positive direct antiglobulin test by tube test and gel microcolumn assay using serum and eluate. None of them had signs of hemolytic anemia. A total of 1,000 blood samples from donors were used as control group. Gel microcolumn assay was more sensitive than in tube test for direct antiglobulin test (P<0.01). Positive direct antiglobulin test was more frequent in patients than in donors (P<0.01). Drug in vitro studies were positive with at least one drug in 76.5% of patients with positive direct antiglobulin test by immune complex and/or adsorption mechanisms. We found a high incidence of positive drug in vitro tests in positive direct antiglobulin test patients. Gel microcolumn assay showed appropriate results for drug in vitro studies. The combination of tube and gel microcolumn assay can improve detection of drug-induced positive direct antiglobulin tests.