Blood Banking part 2 Flashcards
Age of a qualified potential donor
18 - 65 yo
Body weight of a qualified donor
> /= 110 lbs or >/= 50 grams
maximum amount of blood to be drawn
10.5 mL/kg
formula for volume of blood to collect (in mL)
(Donor’s weight / ideal weight) x 450 mL
Formula for the volume of anticoagulant needed (in ml)
(answer in volume of blood to collect / 100) x 14
formula for the volume of anticoagulant to be removed in ml
63 ml - answer in volume of anticoagulant needed
temperature of a qualified blood donor
not exceed 37.5 deg C and 99.5 deg F
pulse of a qualified blood donor
50 - 100 beats/ min
Blood pressure of a qualified blood donor (Henry)
Systolic: not exceed 180 mmHg
Diastolic: not exceed 100 mmHg
Blood pressure of a qualified blood donor (DOH)
Systolic: 90-160 mmHg
Diastolic: 60 - 100 mmHg
age criteria of whole blood donors (allogeneic)
> /= 16 or as allowed by state law
age criteria of whole blood donors (autologous)
As determined by medical director
hemoglobin criteria of whole blood donors (allogeneic)
> /= 12.5 g/dl
hemoglobin criteria of whole blood donors (autologous)
> /= 11 g/dl
hematocrit criteria of whole blood donors (allogeneic)
> /= 38%
hematocrit criteria of whole blood donors (autologous)
> /= 33%
temperature criteria of whole blood donors (allogeneic)
37.5 deg C (99.5 deg F)
temperature criteria of whole blood donors (autologous)
as determined by medical director.
Bacteremia is cause of deferral
venipuncture site criteria of whole blood donors (allogeneic)
No infectious skin disease or scars indicative of drug use
venipuncture site criteria of whole blood donors (autologous)
As determined by medical director
For autologous transfusion, blood may be drawn from patient every __ days but not within ___ hours of surgery
3 days; 72 hours
Specific gravity of copper sulfate
1.053
acceptable drop of blood will sink in copper sulfate solution within ___
15 seconds
deferral for donors who have severe clinical conditions and have infection
permanent
GH that entails permanent deferral
Human-derived GH
GH that entails no deferral
Recombinant GH
deferral of active diseases under treatment
temporary
deferral of curable disease of the heart, lung, kidney, liver and GIT
temporary
deferral of px under treatment with antibiotics
temporary
deferral for Acetretin (Soriatane) for psoriasis
3 days
deferral for incarceration in a jail more than 72 hours
1 year
deferral of people who travel to areas endemic for malaria
1 year
deferral of people with history of syphilis or gonorrhea
1 year
deferral of recent whole blood donation
12 weeks or 3 months
deferral: following delivery of a baby
6 weeks
deferral of German measles (rubella) vaccination
1 month
deferral of contact with rubella but no previous infection
4 weeks
deferral of contact with rubella with previous infection
accept anytime
deferral after cessation of the drug Isotretinoin for severe acne treatment
1 month
deferral after cessation of the drug Finasteride
1 month
deferral of rubeola infection from recovery
6 weeks
whole blood donation deferral after hemapheresis
48 hours
frequency of donation for plateletpheresis
48 hours between donations, up to 24 times/year
frequency of donation for leukopheresis
not more than 2x a week, 24 times/year
frequency of donation for plasmapheresis
every 4 weeks
frequency of donation for red cell apheresis
every 16 weeks
deferment of acute febrile illness
2-3 weeks after episode or until fully recovered
deferment of fever with unknown origin
4 months
deferment of common cold
1 week after recovery
deferment of dengue fever
1 month after recovery if wo blood transfusion
deferment of influenza
1 month after complete recovery
deferment of major operation including dental surgery and blood transfuson
12 months after operation or transfusion
deferment for malaria infection
3 years after treatment
deferment of past exposure to a close household with hepatitis
1 year after exposure
deferment of past exposure to unhygienic skin piercing, tattooing, needle puncture
1 year from procedure
deferment of pregnant women
9 months after childbirth or 3 months after weaning
deferment of recent alcohol intake
12 - 24 hours after intake
deferment of skin lesion at veni site
after healing
deferment of typhoid or salmonella
infection: 3 months from recovery
household contact: 4 weeks from last exposure
deferment of URTI
1 week from recovery
deferment of live attenuated vaccines
2 weeks after vaccination
deferment of rubella vaccine
1 month after vac
deferment of rabies vac
1 yr
deferment of other vaccines
1 month
deferment of killed vaccines and toxoids
may donate anytime (wo fever)
deferment of HPV vac
4 wks
deferment of MMR vac
8 wks
deferment of Japanese encephalitis vac
3 weeks
deferment of COVID-19 vac
accept if asymop
Deferment of anti acne drugs
2 months
Deferment of anti fungal drugs
5 days
Deferment of anti-TB drugs
Until cured
Deferment of antibiotics other than anti-TB drugs
1 month
Deferment of aspirin
Single dose: 3 days
Chronic intake: 3 weeks
Deferment of Clopidogrel, ticlopidine
14 days for platelet donors
Deferment for dutasteride
6 months
Deferment for glutathione
For liver disorder permanent
For cosmetic use 1 year
Deferment of insulin
Permanent
Deferment for MDA for filariasis and schistosomiasis
2 weeks
Deferment of oral corticosteroids
While on treatment
Deferment of penicillin
3 weeks
Deferment of Piroxicam
Chronic: 1 weeks
2 days (AABB)
Deferment of warfarin
1 week
Volume of blood routinely collected
450 ml +/- 10% or 500 ml +/- 10%, depending on collection bag
Maximum volume of collection of whole blood
10.5 ml of blood per kg of donor’s weight
Volumes of anticoagulant
63 ml for 450 ml collection
70 ml for 500 ml collection
Time of collection
Usually <10 minutes
If collected > 15-20 mins, unit may not be suitable for preparation of
Platelets
FFP
Cryoprecipitated Antihemophilic Factor
Storage temp of unit
20 -24 deg C for plts
1-6 deg C for other comp
Chelates calcium to prevent coagulation
Citrate (sodium citrate)
Buffer to prevent decreased pH
Phosphate buffer (sodium biphosphate)
Sugar to support RBC life
Dextrose
Used in ATP synthesis
Adenine
Storage time or ACD, CPD, CP2D
21 days
Storage time of CDPA-1, CPDA-2
35 days
AS are added to rBC after the plasma has been removed from whole blood collected using ___
CPD or CP2D
Final hematocrit of RBC after adding AS
55-65%
storage time of red blood cells with additive solutions
42 days
use in some blood centers to regenerate ATP and 2,3 DPG
Rejuvenation Solutions
The only FDA-approved rejuvenation solutions in US
Rejuvesol
wash rejuvenated RBCs to remove ___
inosine
shelf life of (frozen) rejuvenated RBCs if using CPD and CPDA-1
3- 10 years
shelf life of (frozen) rejuvenated RBCs using AS-1
1-3 years
collected units stored at 1-6 deg C should be submitted in the BB/BC within ___
24 hours
collected units stored at 20 - 24 deg C should be submitted in the BB/BC within ___
6-8 hours
whole blood should be submitted within ___ hours after collection can be used for platelet preparation
6-8 hours
tests done on the donor blood unit
ABO grouping
Rh typing (and Du testing)
Antibody screen (required only on those with previous pregnancy and or transfusion)
Screening tests for TTIs
Blood components prepared using heavy spin (5,000 x g for 5 minutes)
Packed RBC, Platelet concentrate
Blood components prepared using heavy spin (5,000 x g for 7 minutes)
Cryoprecipitate, Cell-free plasma
Blood components prepared using light spin (2,000 x g for 3 minutes)
Platelet-rich plasma (PRP)
pore size of standard filter
170 - 200 um
pore size of microaggregate filter
20 - 40 um
used to remove 99.9% if WBC from RBC and platelet products
leukoreduction filters
Leukoreduced RBC
< 5 x 10^6 WBC
Leukoreduced Random Donor Platelet (RDP)
< 8.3 x 10^5 WBC
Leukoreduced Single Donor Platelet (SDP)
< 5 x 10^6 WBC
washed RBCs are used within
6 hours
washed platelets are used within
4 hours
Plateletpheresis, platelet count of the donor must NOT be less than
150,000/uL
Plasmapheresis total protein must not be less than
6.0 g/dL
used in irradiation
Cesium-137 or Cobalt-60
Irradiate up to ____ days of collection and stored for another __ days
14 days
14 days
Minimum dose of irradiation at the center of the unit
25 Gy
Minimum dose of irradiation in other parts of the unit
15 Gy
Process of recombining 2 DNA fragments from different species and inserting such recombinant molecule into a host organism in order to produce new genetic combinations that are of value in medicine, science, and industry
Recombinant DNA technologt
Components of an open system stored at 1-6 deg C must be used within ___ after system opened
24 hours
Components of an open system stored at 20 - 24 deg C must be used within ___ after system opened
4 hours
Use of blood components to treat a disease in a patient
Hemotherapy
transfusion of specific components rather than whole blood to treat a patient
Component therapy
Main indication for use of RBC
patient hemoglobin is: ___ and or hematocrit is: ___
< 6 g/dL
<18 g/dL
1 unit of Whole blood or 1 unit of Packed RBC can increase hemoglobin by __ and hematocrit by ___
1-1.5 g/dl
3-5%
- Provide blood volume expansion and RBC mass in acute blood loss;
- for actively bleeding px who have lost at least 25% of their blood volume
- px requiring exchange transfusions
Whole blood
storage of whole blood
1-6 deg C (2-6 deg C)
transport of whole blood
1-10 deg C (2-10 deg C)
Shelf life od WB
ACD and CPD
CPDA-1
ACD and CPD = 21 days
CPDA-1 = 35 days
- Indication of RBC mass of symptomatic, normovolemic patients
- For trauma patients, dialysis patients, premature infants, patients with sickle cell anemia, and oncology patients undergoing chemotherapy or radiation therapy
Packed RBCs
storage of PRBC
1-6 deg C (2-6 deg C)
Transport of PRBC
1-10 deg C (2-10 deg C)
shelf life of PRBC
Open system
Close system
Open system: 24 hours
Close system: ACD and CPD = 21 days; CPDA-1 = 35 days
Leukoreduced RBCs are obtained from filtration within __ from time of collection
48 hours
Leukoreduced RBCs must retain ___ % of original RBCs
85%
1 unit of leukoreduced RBC contains ___ WBCs
<5 x 10^6 WBCs
Increase RBC mass in patients with severed and or current febrile transfusion reactions due to leukocyte antibodies
Leukoreduced RBCs
Indication: Increase RBC mass in patients at risk for HLA alloimmunization or susceptible to CMV
Leukoreduced RBCs
Storage of Leukoreduced RBCs
1 -6 deg C (2-6 deg C)
1- 10 deg C during transport
Indication: increase RBC mass of symptomatic anemic patients with transfusion history of allergic, urticartial reaction, anaphylactic reaction, febrile nonhemolytic reaction
Washed RBCs
storage of Washed RBCs
1-6 deg C
Shelf life of washed RBCs
24 hours
used in immunodeficiency, malignancy, bone marrow transplant, transfusion with blood from blood relative, intrauterine and neonatal transfusion
Irradiated RBCs
use for the prevention of graft-vs-host disease
irradiated RBCs
Frozen RBCs are frozen in glycerol within ___ of collection
6 days
For the storage of rare blood and autologous units
Frozen RBCs
Storage and shelf life of frozen RBCs
10 years
after deglycerization: 24 hours
osmolality to monitor glycerol removal
safe for IgA deficient patient
All plasma, anticoagulant, WBCs and platelets removed
Frozen RBCs
for transfusion-dependent individuals (thalassemia, chronic anemia, sickle cell anemia
Neocyte-enriched blood
Neocyte-enriched blood for hemochromatosis
1 RBC unit: ___ iron
200 - 250 mg
main indications for use of platelets
Platelet count is ___
Pre-operation platelet count is ___
<20,000/ul
<50,000/uL
Indication
For bleeding due to thrombocytopenia or thrombocytopathy;
for patients with chemotherapy, post-bone marrow transplant patients, post-operative bleeding
Platelet Concentrate or Random Donor Platelet
NOT indicated with idiopathic thrombocytopenia (ITP)
Platelet Concentrate or Random Donor Platelet
storage of platelet concentrate and random donor platelet
20-24 deg C
shelf life of PC and RDP
5 days from collection with constant agitation
after pooling:: 4 hours
1 Unit of PC or RDP contains
> or = 5.5 x 10^10 platelets
A pool of ___ units will contain roughly 3 x 10 ^11 platelets and should give a plate count increase similar to one SDP unit
4 - 6 units
1 unit of PC or SDP will increase platelets by ___ in 75 kg recipient
5,000 - 10,000/uL
Good increment of PC or RDP
> 10,000/uL
Platelet Refractoriness
< 5,000/uL
Percent recovery of platelets after 1 hour post transfusion and at 24 hours
60% at 1 hr
40% at 24 hrs
Preparation of SDP
Plateletpheresis
indication for thrombocytopenic patients alloimmunized to HLA or platelet antigen (donor should be HLA matched)
Plateletpheresis Unit or SDP
1 unit of SDP contains __
> or = 3.0 x 10^11 platelets
1 Unit of SDP should increase platelets by ___
30, 000 - 60,000/ul
WBCs removed by filtration or during apheresis processing
Filters can reduce a number of WBCs in a bag while being transfused
Leukocyte-reduced platelets
same with SDP or platelet pheresis unit
Leukocyte-reduced platelets
__ ABO identical platelet pooled using closed system
4-6
Indication for severe thrombocytopenia or abnormal platelet function
Pre-storage pooled platelet
in granulocyte apheresis, it is used as a sedimenting agent
Hydroxyethyl starch (HES)
preparation of donor before granulopheresis
administer __ to donor 12-24 hours before donation
corticosteroid or GCSF
indication
patients with granulocyte dysfunction or myeloid hypoplasia who are unresponsive to antibiotics;
severe neutropenia with infection non-responsive to antibiotic therapy
Apheresis Granulocytes or granulocyte pheresis unit
main indication for use of plasma derivatives
PT is
> 16 seconds (INR = 1.5)
main indication for use of plasma derivatives
apPT is
> 60 seconds
main indication for use of plasma derivatives
fibrinogen is
< 100 mg/dl
FFP is prepared from the separation of WB to obtain plasma and frozen within __ hours of collection
8 hours
FFP is stored at 1-6 deg C for up to ___ hours
6 hours
FFP is stored at 4 dec F for up to __ hours if factor VIII is not needed
24 hours
indication
bleeding patients who require factors II, V, VII, IX, X
* replaced isolated factor deficiencies
*reverse effects of warfarin
*treat TTP and HUS
*patient with liver disease to prevent or correct bleeding
* antithrombin III deficiencies; DIC when fibrinogen is <100 mg/dL
Fresh Frozen Plasma
Shelf life of FFP if Frozen (-18 deg C)
1 yr
Shelf life of FFP after thawing: 1-6 deg C)
24 hours
Shelf life of FFP in -65 deg C
7 yrs
amount of fibrinogen in cryoprecipitate
150 - 250 mg
amount of AHF in cryoprecipitate
80 - 120 IU
amount of vwF in cryoprecipitate
40 -70%
amount of factor XIII in cryoprecipitate
20 - 30%
thawed cryoprecipitate is transfused within
6 hours
pooled cryoprecipitate is transfused within
4 hours
indication is for the treatment of fibrinogen deficiency, hemophilia A, VwD, factor XIII deficiency, and as a fibrin sealant
Cryoprecipitate
patients with FVIII deficiency are routinely treated with
FVIII concentrates
Cryoprecipitate is NOT indicated in
TTP
shelf life of single units cryoprecipitate
6 hours
shelf life of pooled units close system
6 hours
used for hemophilia A and vwD only if factor VIII concentrate or recombinant factor preparations not available
Cryoprecipitate
shelf life of FFP if stored at -65 deg C or below
7 years
shelf life of FFP and Cryoprecipitate if stored at -40 to -65 deg C
24 months
shelf life of FFP and cryoprecipitate if stored at -30 to -39 deg C
12 months
shelf life of FFP and cryoprecipitate if stored at -25 to -29 deg C
6 months
shelf life of FFP and cryoprecipitate if stored at -20 to -25 deg C
3 months
shelf life of FFP and cryoprecipitate if stored at -18 deg C
1 yr
plasma may be separated from whole blood at any time during the unit’s shelf life up to ___ days after the expiration
5 days
shelf life of plasma derivatives
5 years when stored between 1 - 6 deg C
products that are transfused in patients sufferring from hypovolemia or indicated among burn and shock patients
plasma volume expander
COmponents of Normal Serum Albumin (NSA)
96% albumin + 4% globulin
Components of Plasma Protein Fraction (PPF)
83% albumin + 17% globulin
a gluelike substance, such as protein or starch,whose particles, when dispersed in a solvent to the possible degree, remain uniformly distributed and fail to form a true solution
Colloid
increased in RBC storage lesion
Lactic acid
Plasma K
Plasma hemoglobin
Microaggregates
decreased in RBC storage lesion
ATP
2,3 DPG
pH
Glucose
Viable cells
Labile coagulation factors
Plasma Na
transport cold chain
room temp (20-24degC0
20 - 24 deg C
transport cold chain if stored at 2-6 deg C
2 - 10 deg C
transport cold chain if stored frozen
with dry ice
color label of blood Group O
Blue
color label of blood Group A
Yellow
color label of Blood Group B
Pink
color label of blood group AB
White
color: hold for further processing
tan
color: for emergency use only
orange
color: for autologous use only
green
color: not for transfusion
Gray
color: irradiated
Purple
color: biohazard
Red
color: from a therapeutic phlebotomy
Chartreuse
the administration of blood or its component intravenously
Transfusion
blood taken from a patient to be used for the same patient
Autologous transfusion
transfer of blood directly from one person to another
Direct transfusion
transfusion of blood from a donor to a suitable container and then to a patient
indirect transfusion
transfusion and withdrawal of small amounts of blood, repeated until blood volume is almost entirely exchanged; used in infants born with hemolytic disease
exchange transfusion
transfusion of blood into a fetus in utero
intrauterine transfusion
standard filter in infusion of blood components
170 um
peripheral vein cannula for transfusion for adults
gauge 18-20
peripheral vein cannula for transfusion for pediatric patients
gauge 22-24
maximum transfusion time allowed for one unit to be transfused
2-4 hours
15 drops = ___ ml
1 ml
at a rate of 60 drops per minute, __ ml of blood can be transfused in 1 hr
240 ml
blood warmer should maintain a temperature of about ____
37 deg C
apheresis blood collection: withdrawal of whole blood, removing selected fraction and reinfusion of the remaining components into the donor
Centrifugation
apheresis blood collection: removal of only plasma through a membrane for normal plasma collection or for therapeutic purposes
Filtration
apheresis blood collection: removal of only a selected constituent of plasma with reinfusion of plasma after constituent removed
Adsorption
done for plateletpheresis for polycythemia vera
therapeutic bleeding
done for leukapheresis for leukemia
therapeutic bleeding
done for plasmapheresis for SLE
therapeutic bleeding
replacement of one or more blood volumes within 24 hours or about 10 units of blood in an adult
Massive blood transfusion
hemolysis with symptoms due to red cell incompatibility
Acute HTR
antibody to leukocyte antigens
Febrile non-hemolytic transfusion reaction
antibody to IgA
Anaphylaxis
antibody to plasma proteins
Allergy or urticaria
antibody to leukocytes or complement activation
Transfusion-related acute lung injury (TRALI) or non-cardiac pulmonary edema
anamestic antibody to red cell antigens
Delayed HTR
engraftment of transfused functional lymphocytes
TA-GvHD
development of antiplatelet antibody
Post-transfusion purpura
tests for HBV
Chemiluminescent assay (ChLIA) or enzyme immunoassay (EIA)
Confirmatory: Neutralization
test for HCV
ChLIA or EIA
Confirmatory: RIBA or recombinant immunoblot
tests for HIV
ChLIA or EIA
Confirmatory for HIV-1: IFA or WB
Confirmatory for HIV-2: IEA
tests for HTLV
ChLIA or EIA
Confirmatory: IFA or Line immunoblot
tests for syphilis
Microhemagglutination or IEA
Solid phase red cell adherence or particle agglutination
Confirmatory: T. pallidium antigen specific immunofluorescence or agglutination assays
tests for West Nile Virus
Transcription-mediated amplification or PCR
Tests for T. cruzi
ChLIA or EIA
Confirmatory: RIPA or Radioimmunoprecipitation assay
routine blood bank techniques and pre-transfusion testing procedures
ABO typing
Rh Typing
Antibody screen
Antibody identification
Crossmatch
discovered by coomb’s, Mourant, and Race
AHG testing
used to detect RBCs sensitized with IgG alloantibodies, IgG autoantibodies, and complement components
AHG testing
detects in vivo sensitization of RBC with IgG and or complement components
DAT
where maternal antibodies coat fetal or neonatal RBC in the fetal or neonatal circulation
HDFN
where recipient antibodies coat donor RBCs
HTR
where autoantibodies and complement components coat individual’s RBCs
AIHA and DIIHA
Detects in vitro sensitization of RBC
IAT
Tubes with no agglutination in DAT and IAT –> add ___
Coomb’s Control Cells
Involves the reaction between serum or plasma with 2-3 reagent phenotyped for multiple antigens
Antibody screen
Incidence of unexpected antibodies
0.2-2%
Current mandated test for pretransfusion samples:
Antibody screen
Determines compatibility of donor RBCs with recipient blood
Crossmatch
Method that demonstrate ABO incompatibility and clinically significant antibodies
Crossmatch
Units to be crossmatched
RBC
Granulocytes
Units that do not need crossmatching
Plasma
Cryoprecipitate
Platelets
Mixing patient’s serum with donor’s red cells
Major crossmatch
Mixing donor’s serum with patient’s red cells
Minor crossmatch
Potentiating media
0.2% NaCL in glycine
Increases antibody uptake
LISS
Potentiating media
Allows sensitized cells to come closer together to form agglutination lattices
Bovine albumin (22% or 30%)
Potentiating media
Concentrates antibodies and creates low-ionic solution to allow greater antibody uptake
Polyethylene glycol (PEG) additive
Potentiating media
Positively charged polymer that reduces zeta potential by neutralizing the negative charge in the red cell
Polybrene
Antibodies enhanced by enzymes
Rh
Lewis
Kidd
P1
I
ABO
Antibodies destroyed by enzymes
Xga
M
N
S
Duffy
Technique used to dissociate IgG antibodies from sensitized RBCs
Elution
Releases antibody by destroying the RBCs
Digitonin
Used to remove IgM antibodies (usually A or B) present on newborn RBCs
Lui freeze-thaw
Process of removing antibody from serum by combining a serum sample with appropriate RBCs
Adsorption
Autoadsorption can be performed if patient was not transfused within the past ____
3 months
Autoanti-I can be adsorbed by
Rabbit RBC
Uses soluble antigen to inhibit the reactivity of certain antibodies in hemagglutination assays
Neutralization
Neutralized by hydatid cyst fluid, pigeon droppings, turtle dove’s egg whites
Anti-P1
Neutralized by saliva, serum or plasma
Anti-Lewis
Neutralized by serum or plasma
Anti-Chido or anti-Rogers
Neutralized by urine
Anti-Sda
Neutralized by breast milk
Anti-I
Chemical used for preparing cells for adsorption
ZZAP/DTT
Chemic tht destroys kell antigens
2-aminoethyliaothiouronium bromide
Bead based assay that uses fluorescence and flow cytometry to test for platelet or HLA antibodies
Luminex-based assay
Fetomaternal hemorrhage may result in ___ ml of fetal blood passing into maternal circulation
30 ml
Common Antibodies identified in prenatal specimens causing HDFN
Rh
Kell
ABO
Rare antibodies identified in prenatal specimens causing HDFN
Duffy
MNSs
Sample to confirm HDFN
Cord blood
Carried out by obtaining fetal cells through amniocentesis or chorionic villous sampling as early as 10 to 12 weeks of gestation
Fetal DNA testing
Gauge the severity of HDFN
Antibody titers
Based on the reduced viscosity at low hematocrit resulting in faster velocity
Middle Cerebral Artery -Peak Systolic Velocity (MCA-PSV) ultrasonography
Transfusion of prbc to the fetus to correct anemia
Intrauterine transfusion
Removal of infant RBcs coated with maternal antibody and replacement with antigen-negative RBCs
Exchange transfusion
Phototherapy wavelengths used
460 to 490 nm
Use of fluorescent blue light in ____ for jaundice
420 to 475 nm
To interrupt transport of maternal antibodies to the fetus
Early delivery
Autoantibody specificity of WAIHA
Anti-Rh precursor
Anti- common Rh
Anti-Lw
Anti-U
Autoantibody specificity of CAS
Anti-I
Anti-i
Anti-Pr
Cold reactive IgM autoagglutinin binds to RBCs in peripheral circulation - IgM binds complement - IgM dissociates leaving RBCs coated only with complement
Cold Agglutinin Syndrome
IgG autoantibody reacts with RBCs in colder parts of the body, causes complement to be bound irreversibly ro RBCS, and then elutes at warmer temperature
PCH
Autoantibody specificity of PCH
Anti-P
Prototype drugs in immune complex
Quinidine and Phenacetin
Small doses of these drugs may cause acute intravascular hemolysis with hemoglobinemia or hemoglobinuria; renal failure common
Quinidine and Phenacetin
Large doses of this drug causes immune hemolysis, usually extravascular
Penicillin
Drug that mimics Warm AIHA
Methyldopa (Aldomet)
