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Biomedical subjects

P L Strohm

Publications and source records attributed to P L Strohm.

12 recordsLinked to original sources
PubMed1996

Neonatal thrombocytopenia caused by passive transfer of anti-PLA1 antibody by blood transfusion.

A premature male infant with hyaline membrane disease received a 34 ml transfusion of packed erythrocytes from a CPDA1 blood unit on day 2 with no adverse consequences. On day 34 he was given a transfusion, and the platelet count decreased. Intravenous immune globulin therapy was initiated and the platelet count steadily increased. Human leukocyte (HLA) antigen and platelet antibody testing showed that the thrombocytopenia was due to passive transfer of platelet-specific antibody from the blood donor.

Antibodies↗
PubMed1991

An empirical evaluation of the performance of antibody identification tasks.

Four empirical studies were conducted for better understanding of the nature of problem-solving activities by medical technologists and medical technology students when performing antibody identification tasks. The results indicated the importance of strategies that ensure the collection of converging evidence, as these strategies protect against the fallibility of commonly used heuristics and against errors due to simple slips. The results also indicate that not only do students make significant numbers of errors, but so do practicing technologists. In one of the studies covering a 1-year period, for instance, a group of 16 technologists made a total of 41 errors in 1057 cases. On the basis of these findings, several alternatives are proposed to reduce errors.

Adult↗
PubMed1991

Procedural errors in antibody identification.

In experimental studies of students and line technologists performing antibody identification procedures, both groups made errors. These errors included, at times, either failing to identify an antibody or misidentifying the specficity(ies)A. prospective study was undertaken to identify errors made in a laboratory setting. Errors were classified as 1) failing to follow protocol (procedural error) or 2) arriving at the wrong answer (misidentification error). Over a 1-year period, 1,057 workups were reviewed. There were 41 (3.88%) procedural errors and no misidentification errors. In 25 workups (61% of errors), the selection of cells m rule out underlying alloantibody(ies) was in error. The remaining 16 involved various "slips" (minor mistakes or memory lapses) and clerical errors. Based on an analysis of the probable causes of these errors, potential solutions include 1) developing computer aids to detect "rule-out" errors or missing tests results; 2) providing timely, careful review of workups before transfusion; and 3) designing better panel layout and cell selection.

Journal Article↗
PubMed1988

Hemolytic disease of the newborn from anti-E. A case report.

Anti-E is rarely acknowledged as a cause of severe hemolytic disease of the newborn. A patient presented with a low titer (32) that increased following repeated amniocentesis, used to evaluate the fetal condition. The infant developed severe disease requiring multiple exchange transfusions but did well and was discharged in good condition.

Adult↗
PubMed1985

Fetomaternal hemorrhage following trauma.

Fetomaternal hemorrhage can result from different types of trauma and may be followed by fetal anemia, fetal death, or isoimmunization. We prospectively studied the frequency and volume of fetomaternal hemorrhage, fetal well-being, abruptio placentae, and fetal outcome in 32 pregnant patients suffering recent trauma. Fetomaternal hemorrhage occurred in nine of 32 trauma patients (28%) with a mean volume of 16 ml +/- 14.3(SD). There was a statistically significant difference in the frequency and mean volume of fetomaternal hemorrhage in this group over that in gestational-age-matched controls. Neither the nature of the trauma nor the gestational age was related to the frequency or volume of fetomaternal hemorrhage. The outcome in three of the nine trauma patients who sustained fetomaternal hemorrhage was poor; fetal anemia, paroxysmal atrial tachycardia, and fetal death occurred in each one. Maternal trauma remains a significant cause of maternal and fetal morbidity and death, and the use of the Kleihauer-Betke analysis is indicated to identify fetomaternal hemorrhage. Rh-immune globulin therapy should be given to Rh-negative patients with fetomaternal hemorrhage.

Abdominal Injuries↗
PubMed1983

Successful transfusion results using Rg(a+) blood in four patients with anti-Rga.

4 patients with anti-Rga successfully transfused in 1979 and 1980 with Rg(a+) donor units are herein reported since the literature lacks information on transfusion results in patients with this alloantibody. The transfusions of both Rg(a+) whole blood and packed red blood cell units caused no discernible immediate or delayed transfusion reactions. Clinically, predicted hematocrit increases were attained and sustained and the laboratory findings showed no evidences of shortened survivals of donors' red blood cells.

Aged↗
PubMed1982

The Hey antigen and antibody. A second family study and the first example of an IgG anti-Hey.

A three generation family with 16 members shows that the Hey red blood cell antigen is not in the Rh, P or Kidd systems. The mother of the proband was found to have an IgG component in her anti-Hey, probably the result of alloimmunization by her two Hey-positive children. the wife of the proband who had 1 Hey-positive child, and 4 recipients of a single unit of Hey-positive blood did not have detectable anti-Hey. The presence of the IgG component of the mother's anti-Hey raises the possibility that both hemolytic disease of the newborn (HDN) and hemolytic transfusion reactions (HTR) could occur due to anti-Hey.

Adult↗
PubMed1982

Anti-Rga: identifying serologic characteristics.

Anti-Rga is a rare alloantibody that is difficult to recognize and identify. Although posing no apparent transfusion risk itself, it can mask the presence of underlying alloantibodies which could be transfusion risks. The five patients reported here demonstrate the serologic findings characteristic of anti-Rga. Known Rg(a-) test cells and multiple "target cells" in neutralization studies are needed to demonstrate partial neutralization findings and to detect underlying alloantibody. Other observations were that clotted samples of red cells retained Rga reactivity for 49 days, whereas EDTA-anticoagulated red cell samples lost such reactivity after 13 days. Frozen red cells tested within hours of deglycerolization showed excellent Rga reactivity.

Aged↗
PubMed1981

Hemolytic transfusion reaction due to anti-Kell undetectable in low-ionic-strength solutions.

Low-ionic-strength solution (LISS) reagents and methodologies have become popular in recent years in hospital transfusion service laboratories for alloantibody detection and compatibility testing of blood recipients. It has been the experience with all other hemagglutination technics that some examples of alloantibodies unpredictably fail to react. Such is the case with this patient's alloantibody with respect to LISS. The patient had a significant hemolytic transfusion reaction due to Kell incompatibility of one unit of packed human erythrocytes. Using various LISS reagents and methodologies, the anti-Kell was undetectable in pretransfusion and posttransfusion samples through the fifth day. The anti-Kell was of immunoglobulin class IgG, and it was detected in saline solution or albumin at room temperature, at 37 C and by the antiglobulin technic.

Aged↗
PubMedDate not supplied

Hemolysis following intravenous immune globulin therapy.

Two patients who had hemolysis after receiving large doses of intravenous immune serum globulin are reported. Both patients had positive direct antiglobulin tests due to alloantibodies contained in the immune serum globulin. Markedly increased red cell transfusion requirements and elevated serum bilirubin levels provided evidence of hemolysis.

Adult↗
PubMedDate not supplied

Anti-Rh33, the second separable example, also made by a person who made anti-D and has C+ red cells.

A complex serologic investigation resulted in identification of the second example of separable anti-Rh33. A patient who had been transfused frequently and who had red cells that lacked a portion or portions of the D mosaic of antigens made anti-D against that portion of D missing from her red cells, anti-c, anti-V, anti-Rh33, anti-K, and an autoantibody that mimicked the reactions of anti-D. Differential adsorption experiments showed that the anti-Rh33 was separable from the other antibodies present. The serologic findings in this case and in the study in which anti-Rh33 was first found show some sort of relationship between D and Rh33. First, one of the genes, RoHar, that makes Rh33 makes a form of D that is difficult to detect. Second, the only other gene thus far known to make Rh33, DIV (C)-, encodes for a form of D from which portions of the D mosaic are missing. Third, both examples of separable anti-Rh33 were made by women who made anti-D and whose red cells were C+.

Blood Grouping and Crossmatching↗