Autoimmune hemolytic anemias and drug-induced immune hemolytic anemia Flashcards
- Warm autoimmune hemolytic anemia is characterized most frequently by which of the following serologic patterns?
a. DAT positive (IgG and C3) and a reactive eluate
b. DAT positive (IgG only) and a nonreactive eluate
c. DAT positive (C3 only) and a reactive eluate
d. DAT positive (IgG and C3) and a nonreactive eluate
a. DAT positive (IgG and C3) and a reactive eluate
- . In cold agglutinin syndrome, the DAT is usually positive for:
a. C3 only
b. IgG only
c. IgG plus C3
d. neither IgG nor C3
a. C3 only
- Which of the following is characteristic of paroxysmal cold hemoglobinuria?
a. the autoantibody is usually IgM
b. the antibody is biphasic
c. the antibody is usually detected in pretransfusion tests
d. the antibody has a high titer at 4C
b. the antibody is biphasic
- Autologous adsorptions should not be used when:
a. the patient has never been transfused
b. the patient has a history of anti-Jka but has not been
transfused within the last 3 months
c. the patient received two units of RBCs last month
d. none of the above
c. the patient received two units of RBCs last month
- A child with clinical signs of hemolytic anemia was admitted to the emergency room. He had a viral infection last week and his mother noticed that his urine was red. The DAT is positive with anti-C3 only and the antibody detection test was negative. Which of the following is a possible diagnosis?
a. WAIHA
b. CAS
c. PCH
d. none of the above
c. PCH
- Which of the following is the least encountered reason
for a positive IgG DAT with a nonreactive eluate?
a. drug-dependent antibody
b. anti-A or anti-B from plasma-containing product(s)
c. nonimmunologic IgG uptake due to increased plasma IgG
d. none of the above
a. drug-dependent antibody
- A patient presents with hemolytic anemia and a history of receiving Zosyn (piperacillin tazobactam) just prior to the start of hemolysis. The DAT is positive (IgG
+ C3). What testing should be performed?
a. test serum versus piperacillin-treated RBCs
b. test serum versus untreated RBCs and enzymetreated RBCs in the presence of piperacillin
c. test serum versus tazobactam-treated RBCs
d. test serum versus untreated RBCs and enzyme treated RBCs in the presence of tazobactam
e. both b and d
e. both b and d
- A patient receiving ceftriaxone develops hemolytic anemia. The DAT is positive (IgG+C3). The patient’s serum reacts with all test RBCs (no drug added) by the
indirect antiglobulin test, but an eluate prepared from the patient’s RBCs is nonreactive. Which is the most
likely explanation for these results?
a. idiopathic warm autoantibody
b. drug-independent antibody (e.g., due to fludarabine)
c. circulating drug (or drug-immune complexes) in the patient’s sample
d. Nonimmunologic protein adsorption
c. circulating drug (or drug-immune complexes) in the patient’s sample
- In 2008, cefotetan was the most common reported cause of DIIHA. True or false?
True
- A patient is suspected of having hemolytic anemia due to a drug that has not been previously described as causing DIIHA. Drug-treated RBCs are prepared in the laboratory and tested with the patient’s serum and an eluate from the patient’s RBCs. Which of the following
is not true of results with drug-treated RBCs?
a. nonreactive results with the patient’s samples proves that no drug antibody is present
b. antiglobulin test reactivity with all normal sera indicates the possibility of nonimmunologic protein adsorption
c. direct agglutination after the 37C incubation with some normal sera indicates the possibility of IgM antibodies to the drug (or a structurally similar chemical)
d. reactivity of the patient’s serum and eluate and nonreactive results with normal sera indicates the presence of an antibody to the dru
a. nonreactive results with the patient’s samples proves that no drug antibody is present
