温冷双抗体型自身免疫性溶血性贫血患者ABO正反定型不符1例

A case report:autoimmune hemolytic anemia patients with warm and cold mixed antibodies caused the ABO to be inconsistent

目的鉴定1例温冷双抗体型自身免疫性溶血性贫血患者血型,并进行交叉配血纠正贫血。方法使用微柱凝胶法、试管法进行血型鉴定、直接抗人球蛋白试验、不规则抗体筛查等,二磷酸氯喹吸收放散、冷凝集素效价测定、冷抗体吸收后进行进一步血型鉴定及交叉配血。结果该患者直接抗人球蛋白试验抗IgG、抗C3d均为阳性,冷凝集素试验阳性,最高效价为1∶128,为温冷双抗体型自身免疫性溶血性贫血患者。经吸收放散及冷抗体吸收试验后,鉴定该患者血型为B型,Rh(D)阳性。保温条件下输注B型洗涤红细胞7U,输注有效,无不良输血反应。结论在临床输血工作中,正确鉴定血型,判断自身抗体性质及是否有同种抗体对选择合适的血液十分重要。

Objective The blood type of one case of the autoimmune hemolytic anemia in a warm and cold double antibody was identified and the blood transfusion was used to correct the anemia.Methods Microcolumn gel method,test tube method for blood type identification,direct anti-human ball protein test,irregular antibody screening and so on.Chloroquine absorption,condensate and cold antibody were used to identify and cross blood.Results The patient′s direct anti-human globulin test was positive for anti-IgG and anti-C3d.The maximum effect of the condensation set was 1:128,and the patient had the autoimmune hemolytic anemia with warm and cold double antibody.After absorbing the release and cold antibody absorption test,the patient′s blood type is B.After the infusion of washing red blood cell 7U,the patient′s anemia was corrected.Conclusion In the case of clinical transfusion,proper identification of blood type,the nature of the antibody and whether the same antibody is important to the appropriate blood.