Auto Immune Hemolytic Anemia Part 2

Question 0

Cold Auto absorption procedure…

Answer 0

aliquots of patient’s own cells are used to remove autoantibody from patient’s serum at 4’C, leaving alloab in absorbed serum; only performed if no recent transfusions in the last 3 months; test adsorbed serum at 37’C-AHG

Question 1

purpose is to remove the cold autoantibody from serum so underlying alloantibodies can be detected

Answer 1

Cold Autoadsorption

Question 2

Demonstrates Anti-P specificity and is a diagnostic test (DL Test) used for paroxysmal cold hemoglobinuria (PCH)

Answer 2

Donath-Landsteiner test

Question 3

Procedure for Donath Landsteiner Test

Answer 3

2 red top (serum) tubes drawn from patient and kept at 37’C; control tube remains at 37’C; the “test tube” is incubated at 4’C and then back to 37’C, centrifuge and look for hemolysis in both tubes; hemolysis is + in PCH

Question 4

purpose is to remove the antibody coating the cells when patient cells can’t be AHG-antigen typed by routine methods (such as in WAIHA)

Answer 4

EGA or CDP Treatment of patient cells

Question 5

This is performed when IgG antibody is coating the cells in order to ID the antibody

Answer 5

Elutions

Question 6

Eluate testing against a panel of cells is _________; which is diagnostic for warm autoab

Answer 6

panreactive

Question 7

Tests used to detect underlying clinically significant alloab in the presence of warm autoab

Answer 7

adsorption (DAT, Elution with EGA/CDP treated patient cells, IAT)

Question 8

adsorption where patient can’t have been transfused in the past 3 months

Answer 8

Autoadsorption using paitent’s own cells

Question 9

adsorption where patient has been recently transfused and therefore must use donor cels that have patient’s same phenotype

Answer 9

Homologous Adsorption

Question 10

adsorption most common in reference labs using 3 donors with known phenotype for all other blood groups

Answer 10

Differential adsorption or “Triple” Adsorption

Question 11

Effect of a positive DAT on weak D or other AHG-ag typings

Answer 11

since the patient cells are already coated with antibody the AHG/Weak D will always be positive unless treated

Question 12

WAIHA will have _______ autocontrol, HTLAs will have a ______ autocontrol

Answer 12

positive, negative

Question 13

WAIHA is _______ with ficin/PEG/Gel than LISS; HTLA are _______ with the media

Answer 13

enhanced; variable

Question 14

WAIHA is ______ with all cells; HTLAs are ________ if tested against antigen negative cells

Answer 14

positive, negative

Question 15

shortened red cell survival due to immune response (antibody production)

Answer 15

Immune Hemolytic Anemia (IHA)

Question 16

antibodies being directed against an individual’s own RBCs

Answer 16

autoantibodies