A patient with warm autoimmune hemolytic anemia (AIHA) has been found to possess an autoantibody with Wrb specificity. While this is the first known description of Wrb specificity in this disease, additional studies on the Wrb status of En(a-) cells indicate that autoantibodies previously thought to be anti-Ena are in reality also anti-Wrb. Autoantibodies with Wrb specificity may thus be a rather common finding in patients with AIHA who have been thought to have "panagglutinins" on their red blood cells. Since anti-Wra alloantibodies are found frequently in patients with AIHA, it seems possible that the Wright system holds some clue to the pathogenesis of this disease.

Anemia, Hemolytic, Autoimmune↗

PubMedDate not supplied

An En(a-) red cell sample that types as Wr(a-b-).

In the course of investigating a patient with autoimmune hemolytic anemia in which the causative autoantibody had anti-Wrb specificity, it was demonstrated that an En(a-) red blood cell sample typed as Wr(a-b-). The only known example of Wr(a+b-) blood typed as En(a+) so that anti-Wrb and anti-Ena do not have the same specificity.

Anemia, Hemolytic, Autoimmune↗

PubMedDate not supplied

Matuhasi-Ogata phenomenon involving anti-ampicillin.

A 47-year-old group A, Rh1Rh1 woman treated with intravenous ampicillin for chronic pyelonephritis received two units of blood and also received oral cephalexin. Three months after the transfusions she was noted to have allo-anti-E and anti-c, and a 2+ positive direct antiglobulin test. Anti-E and anti-c could be eluted from her cells, yet neither antigen could be demonstrated on the patient's circulating red blood cells. Also present in the serum and in the eluate was anti-ampicillin antibody. Studies of the patient's red blood cell eluates using ampicillin-treated R1R1 and untreated R2R2 cells demonstrated anti-E complexed with anti-ampicillin in a drug-related example of the Matuhasi-Ogata phenomenon. Artificially created mixtures of anti-E and drug antibody could reproduce the effect in vitro. No effect of cephalexin could be demonstrated. The variability of the Matuhasi-Ogata phenomenon is discussed with regard to the sequence of antibody attachment, and the possible relationship to cephalexin is discussed. Drug antibodies may be involved in the Matuhasi-Ogata phenomenon in cases where another red blood cell antibody cannot be shown to be present.

Ampicillin↗