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CCHS SBB > Platelet and Granulocyte Antigens and Antibodies > Flashcards

Platelet and Granulocyte Antigens and Antibodies Flashcards

1
Q

how does expression of ABO antigens on platelets occur?

A

adsorption from plasma and material that is intrinsic to surface membrane of the platelet

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2
Q

where are HLA antigens found?

A

nucleated cells

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3
Q

platelets are part of what HLA class?

A

class I

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4
Q

what HLA antigens are associated with platelets

A

HLA-A and HLA-B

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5
Q

what is responsible for primary HLA alloimmunization in patients who have been transfused platelets?

A

residual white cells

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6
Q

how long after platelet transfusion is platelet response measured?

A

10-60 minutes

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7
Q

what defines a platelet refractory state?

A

post-transfusion CCI of <5000-7500 following 2 consecutive platelet transfusions

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8
Q

most common immune cause of platelet refractoriness

A

HLA sensitization

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9
Q

nonimmune-related reasons for recipient platelet refractoriness

A

massive bleeding, fever, sepsis, splenomegaly, DIC, allogeneic transplant, drugs, TTP

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10
Q

how is HLA sensitization diagnosed

A

microlymphocytotoxicity testing

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11
Q

corrected count increment calculation

A

(BSA x plt ct increment) / number of platelets transfused

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12
Q

post-transfusion platelet recovery calculation

A

(total blood volume x plt ct increment) / number of plts transfused

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13
Q

total blood volume estimate in adult patients

A

75 ml/kg

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14
Q

expected platelet count increase from platelet concentrate

A

5,000-10,000

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15
Q

expected platelet count increase from apheresis platelet

A

30,000-60,000

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16
Q

transfusion requirement for HLA-matched platelets

A

irradiation to prevent GVHD

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17
Q

transfusion options for platelet refractoriness

A

crossmatched platelets
HLA-matched platelets
antibody specificity prediction

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18
Q

most widely used method for platelet crossmatching

A

solid-phase red cell adherence

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19
Q

5 platelet specific antigens characterized as alloimmunogenic and polymorphic

A

GPIa, -Ib, -IIb, -IIIa, CD109

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20
Q

alternative approach to HLA-matched and crossmatched platelets determining recipient’s HLA antibody specificity and then selecting platelet donors who lack antigens to antibodies produced by the recipient

A

antibody specificity prediction

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21
Q

prevention of HLA alloimmunization from platelet transfusion

A

leukocyte reduction

UVB irradiation

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22
Q

HPA-1a antigen frequency

A

98% of white population

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23
Q

most commonly encountered platelet-specific antibody identified in white population

A

anti-HPA-1a

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24
Q

HPA-1b platelet antigen frequency

A

27% of white population

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25
Q

location of HPA-1a and HPA-1b

A

GP111a platelet membrane glycoprotein

26
Q

disease state in which patients lack GP111a glycoprotein and don’t express HPA-1 antigens

A

Glanzmann thrombasthenia type 1

27
Q

major complication of neonatal alloimmune thrombocytopenia

A

major bleeding that can lead to intracranial hemorrhage

28
Q

confirmation test to diagnose neonatal alloimmune thrombocytopenia

A

platelet-specific antibody within maternal serum and corresponding incompatibility for the antigen in parental platelet types

29
Q

treatment of neonatal alloimmune thrombocytopenia

A

IVIG with or without compatible platelet transfusions

30
Q

most common platelet antigen incompatibility in neonatal autoimmune thrombocytopenia

A

HPA-1a

31
Q

identified when patient experiences sudden, dramatic, self-limiting form of thrombocytopenia ~5-10 days after blood transfusion coinciding with potent platelet-specific alloantibody

A

posttransfusion purpura

32
Q

treatment of posttransfusion purpura

A

IVIG

33
Q

diagnosis of posttransfusion purpura

A

genotyping and platelet antibody assays

34
Q

platelet antibody detection method type: assays mixing patient serum with normal platelets using platelet function-dependent endpoints

A

phase I

35
Q

platelet antibody detection method types: measures surface or total platelet-associated immunoglobulin

A

phase II

36
Q

platelet antibody detection method types: solid-phase assays, binding of antibodies to isolated platelet surface glycoproteins

A

phase III

37
Q

platelet antibody detection assay in which intact platelets are immobilized in round-bottom wells of microtiter tray, incubated with patient’s serum, washed, antibody specific coated red cells added, incubate, centrifuge, visually examine

A

mixed passive hemagglutination assay

38
Q

drawback of mixed passive hemagglutination assay platelet antibody detection

A

fails to distinguish non-platelet-specific from platelet-specific antibodies

39
Q

mixed passive hemagglutination assay is phase _ type of platelet antibody testing

A

I

40
Q

flow cytometry is phase __ type of platelet antibody detection

A

II

41
Q

platelet antibody detection assay often used for platelet crossmatching using immunofluorescence

A

flow cytometry

42
Q

monoclonal antibody-specific immobilization of platelet antigen assay is phase ___ type of platelet antibody detection

A

III

43
Q

platelet antibody detection method that requires use of murine monoclonal antibodies that can recognize target antigens

A

monoclonal antibody-specific immobilization of platelet antigen

44
Q

chronic immune thrombocytopenia usually seen in what patient population?

A

adults

45
Q

first line therapy for chronic ITP

A

steroids or IVIG

46
Q

autoantibodies directed against platelet antigens could result in what pathological conditions?

A

immune thrombocytopenia or immune thrombocytopenic purpura

47
Q

acute IPT usually seen in what patient population

A

kids

48
Q

first line therapy for acute ITP

A

IVIG or anti-D immunoglobulin infusions given to D-positive patients

49
Q

platelet autoantibody classes

A

IgG, IgM, IgA

50
Q

complication of drug therapy in treatment for platelet autoantibodies

A

thrombocytopenia caused by drug-induced platelet antibodies

51
Q

common drugs associated with drug-induced thrombocytopenia

A

quinine/quinidine, sulfa, heparin, colloidal-gold

52
Q

testing for drug-dependent platelet antibodies

A

flow cytometry, SPRCA assay

53
Q

drug-induced immune response to platelets triggered by widespread use of heparin

A

heparin-induced thrombocytopenia

54
Q

clinical syndromes that implicate antibodies against neutrophil antigens

A

neonatal alloimmune neutropenia
TRALI
immune neutropenia after HPC transplant
refractoriness to granulocyte transfusion
chronic benign autoimmune neutropenia or infancy

55
Q

implemented by maternal antibodies against antigens on fetal granulocytes

A

neonatal alloimmune neutropenia

56
Q

antigens associated with neonatal alloimmune neutropenia

A

HNA-1a, HNA-1b, HNA-2a

57
Q

treatment of neonatal alloimmune neutropenia

A

antibiotics, plasma exchange, IVIG, granulocyte colony-stimulating growth factor

58
Q

characteristic symptoms of TRALI

A

hypo or hypertension, respiratory distress, noncardiogenic pulmonary edema

59
Q

TRALI commonly seen within 2 hours of what blood component

A

plasma-containing components

60
Q

TRALI brought on by antibodies towards what?

A

granulocyte-specific antigens or antibodies to HLA antigens

61
Q

autoantibody implicated in autoimmune neutropenia

A

HNA-1a or HNA-1b

62
Q

testing for granulocyte antibodies

A

combination of agglutination and immunofluoresence

CCHS SBB (40 decks)

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