抗E不规则抗体合并类E自身抗体分析--附1例报告

Analysis on irregular antibodies combined with mimicking antibodies of anti-E

目的通过对1例同时检出抗E不规则抗体及类E自身抗体患者的抗体鉴定,分析类抗体的检测思路和血清学特征。方法复旦大学附属中山医院厦门医院于2021年10月12日收治1例由外院转入有多次输血史的患者,因存在自身抗体影响不规则抗体鉴定,入院后检测ABO血型、Rh血型,进行抗体筛查、抗体特异性鉴定、直接抗人球蛋白实验、吸收放散实验和聚乙二醇(PEG)增强试验。结果患者为41岁女性,因膀胱结石和膀胱阴道瘘入院,曾在外院输血5次。入院后血型鉴定及抗体筛查结果为A型、CcDee,抗筛实验阳性,自身细胞反应阳性。进行特异性抗体鉴定,检出患者体内存在抗E不规则抗体,选用O型Rh表型为CCee,Kidd表型为Jk(a-b+)、Lewis表型为Le(a-b-)的谱红细胞进行吸收放散实验,确定患者体内还存在类E自身抗体。结论该患者在经过多次输血免疫刺激后,同时产生抗E不规则抗体和类E自身抗体。在输血前进行不规则抗体筛查与特异性鉴定很有必要。

Objective To identify a patient with simultaneously detected anti-E irregular antibody and mimicking antibodies of anti-E,and to analyze the detection idea and serological characteristics.Methods A patient with multiple blood transfusions in other hospital was admitted in Zhongshan Hospital(Xiamen),Fudan University on October 12,2021.The presence of autoantibodies affected the identification of irregular antibodies,the ABO and Rh blood type,antibody screening,antibody specificity identification,direct anti-human globulin test,absorption and diffusion test and PEG enhancement test were carried out.Results The patient was a 41-year-old female admitted in hospital due to vesical calculus and vesicovaginal fistula,and received blood transfusion for 5 times.The results of blood type identification and antibody screening were A type and CcDee,anti-screening test and the self-cell reaction were positive.The specific antibody identification was carried out,and the anti-E irregular antibody was detected.The red blood cells of spectrum cells with O type,Rh CCee,Jk(a-b+)and Le(a-b-)were subjected to absorption-elution test to determine the presence of mimicking antibodies of anti-E.Conclusions The patient produced both anti-E irregular antibody and mimicking antibodies after multiple transfusion immune stimulation.It is necessary to screen irregular antibodies and identify their specificity before blood transfusion.