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中华诊断学电子杂志 ›› 2021, Vol. 09 ›› Issue (03) : 187 -191. doi: 10.3877/cma.j.issn.2095-655X.2021.03.011

临床研究

多凝集红细胞致患儿交叉配血次侧凝集的诊断特征分析
孔凡生1,(), 耿微1   
  1. 1. 272113 济宁市中心血站血型参比实验室
  • 收稿日期:2020-10-09 出版日期:2021-08-26
  • 通信作者: 孔凡生

Diagnostic feature analysis of secondary agglutination of cross matching in children caused by polyagglutination of red blood cells

Fansheng Kong1,(), Wei Geng1   

  1. 1. Blood Type Reference Laboratory, The Blood Center of Jining, Jining 272113, China
  • Received:2020-10-09 Published:2021-08-26
  • Corresponding author: Fansheng Kong
引用本文:

孔凡生, 耿微. 多凝集红细胞致患儿交叉配血次侧凝集的诊断特征分析[J]. 中华诊断学电子杂志, 2021, 09(03): 187-191.

Fansheng Kong, Wei Geng. Diagnostic feature analysis of secondary agglutination of cross matching in children caused by polyagglutination of red blood cells[J]. Chinese Journal of Diagnostics(Electronic Edition), 2021, 09(03): 187-191.

目的

探讨多凝集红细胞致患儿交叉配血次侧凝集的特点及检测方法。

方法

回顾性分析2019年1月至12月济宁市中心血站血型参比实验室收到的8例交叉配血次侧凝集患儿标本的检测结果。经ABO和Rh血型鉴定、直接抗人球蛋白试验、抗体筛查和交叉配血等方法,排除假凝集;采用3份正常成人ABO同型血清、3份正常成人AB型血清和花生凝集素确认多凝集红细胞。

结果

8例患儿红细胞直接抗人球蛋白试验阴性;抗体筛查阴性;交叉配血主侧阴性,次侧盐水法和抗人球蛋白法均为阳性;患儿红细胞与正常成人ABO同型血清、AB型血清和花生凝集素均呈凝集反应,盐水法排除缗钱状假凝集。

结论

多凝集红细胞与绝大多数成年人血清发生凝集反应,从而导致交叉配血次侧阳性。确认红细胞多凝集现象,有助于明确交叉配血困难的原因,避免延误患儿输血。

Objective

To investigate the characteristics and detection methods of secondary agglutination of cross matching in children with polyagglutination of red blood cells (RBCs).

Methods

The detection results of 8 child cases with cross matching secondary hemagglutination from January to December 2019 in Blood Group Reference Laboratory of Jining Blood Center were retrospectively analyzed. After ABO and Rh blood type identification, direct antiglobulin test (DAT), antibody screening and cross matching methods, false agglutination was excluded. Polyagglutinated RBCs were confirmed by 3 normal adults of homotypic blood serum, 3 normal adult AB serum and peanut agglutinin.

Results

In the 8 cases, the DAT of RBCs antibody screenings and the primary side of cross matching blood were negative. While the results from the secondary saline method and anti-human globulin method were positive. The RBCs of the children were agglutinated with AB serum and peanut agglutinin. All the elements showed an agglutination reaction, and the saline was used to eliminate false agglutination like rouleaux.

Conclusions

The polyagglutinated RBCs agglutinate with most adults sera, which lead to secondary positive in cross matching test. Confirming the polyagglutination of erythrocytes will help to identify the causes of cross matching difficulties and avoid delaying transfusion for child patients.

表1 8例患儿血型鉴定结果
表2 8例患儿多凝集红细胞确认结果
[1]
Jajosky RP, Cook LO, Manaloor E,et al.Hematologic complications in a patient with glycinesoja polyagglutination following fresh frozen plasma transfusion[J].Immunohematology,2017,33(2): 51-55.
[2]
Melland C, Hintz C.Detecting polyagglutinable red blood cells[J].Immunohematology,2018,34(3): 113-117.
[3]
Chang CJ, Chiu NC, Huang FY,et al.Predictive value of Thomsen-Friedenreich antigen activation for Streptococcus pneumoniae infection and severity in pediatric lobar pneumonia[J].J Microbiol Immunol Infect,2019,52(4): 571-577.
[4]
Karacosta LG, Fisk JC, Jessee J,et al.Preclinical analysis of JAA-F11,a specific anti-thomsen-friedenreich antibody via immunohistochemistry and in vivo imaging[J].Transl Oncol,2018,11(2): 450-466.
[5]
Horn KD.The classification,recognition and significance of polyagglutination in transfusion medicine[J].Blood Rev,1999,13(1): 36-44.
[6]
汪德清.输血技术操作规程(输血科部分)[M].北京:人民卫生出版社,2016:13-63.
[7]
桂荣,张志昇,王勇军.输血相容性检测及疑难病例分析[M].北京:人民卫生出版社,2018:314-316.
[8]
Judd WJ, Johnson ST, Storry JR.Judd′s methods in immunohematology[M]. 3th ed. Bethesda,MD:AABB Press, 2008:559-569.
[9]
朱碎永,朱燕英,林甲进.肠道疾病引起红细胞T活化的检查分析[J].中国实验诊断学,2007,11(3): 296-297.
[10]
Ju T, Wang Y, Aryal RP,et al.Tn and sialyl-Tn antigens,aberrant O-glycomics as human disease markers[J].Proteomics Clin Appl,2013,7(9/10): 618-631.
[11]
Ju T, Aryal RP, Kudelka MR,et al.The cosmc connection to the Tn antigen in cancer[J].Cancer Biomark,2014,14(1): 63-81.
[12]
Rinaudo-Gaujous M, Talagrand E, Verhoeven PO,et al.A case report of Streptococcus pneumoniae-induced hemolytic uremic syndrome:appropriate transfusional management by T-antigen determination[J].Ann Biol Clin (Paris),2013,71(2): 215-218.
[13]
Burin des Roziers N, Chadebech P, Bodivit G,et al.Red blood cell Thomsen-Friedenreich antigen expression and galectin-3 plasma concentrations in Streptococcus pneumoniae-associated hemolytic uremic syndrome and hemolytic anemia[J].Transfusion,2015,55(6): 1563-1571.
[14]
Dinkla S, van Eijk LT, Fuchs B,et al.Inflammation-associated changes in lipid composition and the organization of the erythrocyte membrane[J].BBA Clin,2016,3(5): 186-192.
[15]
Daniels G.Human Blood Groups[M].3th ed.NJ:Wiley-Blackwell,2013:515-523.
[16]
Sas SS.In-house preparation of lectin panel and detection of Tn polyagglutination[J].Asian J Transfus Sci,2015,9(1): 102-103.
[17]
Gorakshakar AC, Ghosh K.Use of lectins in immunohematology[J].Asian J Transfus Sci,2016,10(1): 12-21.
[18]
Williams RA, Brown EF, Hurst D,et al.Transfusion of infants with activation of erythrocyte T antigen[J].J Pediatr,1989,115(6): 949-953.
[19]
Wenzel CQ, Mills DC, Dobruchowska JM, et al. An atypical lipoteichoic acid from Clostridium perfringens elicits a broadly cross-reactive and protective immune response[J].J Biol Chem,2020,295(28): 9513-9530.
[20]
Moh-Klaren J, Bodivit G, Jugie M,et al.Severe hemolysis after plasma transfusion in a neonate with necrotizing enterocolitis,Clostridium perfringens infection,and red blood cell T-polyagglutination[J].Transfusion,2017,57(11): 2571-2577.
[21]
Roseff SD.Cryptantigens: time to uncover the real significance of T-activation[J].Transfusion,2017,57(11): 2553-2557.
[22]
Boralessa H, Modi N, Cockburn H, et al.RBC T activation andhemolysis in a neonatal intensive care population: implications for transfusion practice[J].Transfusion,2002,42(11): 1428-1434.
[23]
Wang LY, Chan YS, Chang FC, et al. Thomsen-Friedenreich activation in infants with necrotizing enterocolitis in Taiwan[J].Transfusion,2011,51(9): 1972-1976.
[24]
Stöllberger C, Krutisch G, Finsterer J.Life-threatening epistaxis and red blood cell polyagglutination under dabigatran[J].Blood Coagul Fibrinolysis,2014,25(4): 384-386.
[25]
Wen L, Liu D, Zheng Y,et al.A one-step chemoenzymatic labeling strategy for probing sialylated thomsen-friedenreich antigen[J].ACS Cent Sci,2018,4(4): 451-457.
[26]
Heublein S, Egger M, Zhu J,et al.Evaluation of the anti-Thomsen-Friedenreich antibodies Nemod-TF1 and Nemod-TF2 as prognostic markers in breast cancer[J].Breast Cancer Res Treat,2020,179(3): 643-652.
[27]
Santarsia S, Grosso AS, Trovão F,et al.Molecular recognition of a Thomsen-Friedenreich antigen mimetic targeting human galectin-3[J].ChemMedChem,2018,13(19): 2030-2036.
[28]
黄园园,刘亚楠,于世鹏.CD4+T淋巴细胞相关细胞因子与桥本甲状腺炎发病机制的研究进展[J/CD].中华诊断学电子杂志,2020,7(3): 214-216.
[29]
Beck ML.Red blood cell polyagglutination: clinical aspects[J].Semin Hematol,2000,37(2): 186-196.
[30]
De Leo D, Antonello O. A case of polyagglutination[J]. Z Rechtsmed,1983,90(2): 147-152.
[31]
Xu F, Wang D, Cui J,et al.Demethylation of the cosmc promoter alleviatesthe progression of breast cancer through downregulation of the Tn and sialyl-Tn antigens[J]. Cancer Manag Res,2020(12): 1017-1027.
[32]
Kaczmarek R, Mikolajewicz K, Szymczak K,et al.Evaluation of an amino acid residue critical for the specificity and activity of human Gb3/CD77 synthase[J].Glycoconj J,2016,33(6): 963-973.
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