Irregular isoantibodies in the sera of patients undergoing chronic hemodialysis
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As a long survival of the patients on chronic hemodialysis has become possible for the establishment of hemodialytic therapy, we began to face the problem of various new complications.The study was carried out on irregular isoantibodies found in the patients on chronic hemodialysis.For the screening of irregular isoantibodies, the saline method, the albumin method, the antiglobulin method and the bromelin method were used in combination, in the patients before and every 3 to 6 months after the induction of hemodialysis.Furthermore, the identification test was performed in the patients who had shown positive results on the screening.As a result, irregular isoantibodies were found in 2 patients who had had neither blood transfusion nor clinical symptoms.The first patient had anti-HI antibody and the titer was twice the normal range.The blood group of this patient was A1, Rh1rh1 (CcDee), NNss, Le(a+b-), P2, and the direct antiglobulin test was negative. Moreover, cold hemoagglutinin titer using Type O adult human red cells was 32 times as high as normal.From these results, it was concluded that the irregular isoantibody observed in this patient was cold hemoagglutinin having the specificity to HI substances.The second patient had anti-P1 antibody, which titer was twice the normal. This patient's blood group was A1, Rh1Rh1 (CCDee), MMss, Le(a-b-), P2, and the direct antiglobulin test was negative.The case reports in regard to the irregular isoantibody in the patientson chronic hemodialysis have been extremely rare in Japan to our knowledge. However, our study showed that the incidence of irregular isoantidodies observed in the patients on chronic hemadialysis was much higher than those found in the multiparae in whom irregular isoantibodies were used to consider most frequent in occurrence. It is easily anticipated that the existance of irregular isoantibodies in the patients on chronic hemodialysis is the extremely important clinical significance, because of their high liability to blood transfusion, surgical operations and future kidney transplantation.Our study suggests strongly the necessity of routine screening test for irregular isoantibodies in the patients on chronic hemodialysis.
- 社団法人 日本透析医学会の論文
社団法人 日本透析医学会 | 論文
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