中国输血杂志2024,Vol.37Issue(2) :214-218,237.DOI:10.13303/j.cjbt.issn.1004-549x.2024.02.015

同种抗-C、e伴类同种抗-e、Jkb自身抗体的鉴定及输血治疗

Dentification and blood transfusion therapy of anti-C,e alloantibodies with anti-e,Jkb mimicking alloantibodies

邹昕 马思飞 杨红梅 范小杰
中国输血杂志2024,Vol.37Issue(2) :214-218,237.DOI:10.13303/j.cjbt.issn.1004-549x.2024.02.015

同种抗-C、e伴类同种抗-e、Jkb自身抗体的鉴定及输血治疗

Dentification and blood transfusion therapy of anti-C,e alloantibodies with anti-e,Jkb mimicking alloantibodies

邹昕 1马思飞 1杨红梅 1范小杰2
扫码查看

作者信息

  • 1. 江苏省常州市中心血站,江苏常州 213000
  • 2. 江苏省常州市第一人民医院检验科
  • 折叠

摘要

目的 应用吸收放散和效价积分法对1例抗-C、e同种抗体合并抗-e、Jkb类同种自身抗体进行鉴别诊断.方法 采用试管法对ABO、Rh和Kidd血型抗原进行鉴定;盐水、凝聚胺、微柱凝胶3种方法联用2套谱细胞进行抗体筛查及抗体特异性鉴定;多重吸收放散试验和效价积分原则对抗体进一步确认;多重PCR技术对RHCE基因、JK基因进行测序.结果 通过血清学分析,该患者血型为A型、Rh分型ccDEE,直抗阳性.结合不同的Rh和Jk表型细胞吸收放散试验以及效价积分原则得出患者血清中含有抗-C、e同种抗体以及抗-e、Jkb类同种自身抗体,红细胞上有抗-e、Jkb类同种自身抗体.基因测序分析RHCE基因第5外显子676位出现G>C,其余外显子没有发生突变,推断Rh分型ccEE型;JK基因中第9外显子838 G/A杂合,Jk血型表型Jk(a+b+),选择交叉配血相合的A型ccDEE、Jk(a+b-)红细胞给患者输注,输血效果良好.结论 应用吸收放散试验和效价积分法对患者血清进行抗体鉴定,以及血清学结合分子生物学对患者红细胞表型鉴定,可综合分析及区分出抗体的类型,为患者精准输血提供方案.

Abstract

Objective To investigate the differential diagnosis of 1 anti-C,e alloantibodies combined with anti-e,Jkb mimicking alloantibodies by absorption-elution test and titer integral method.Methods ABO,Rh and Kidd blood group an-tigens were identified by tube method.Two sets of panel cells were used for antibody screening and antibody specificity iden-tification by saline method,polyamine method and microcolumn gel method.The antibody was further confirmed by multiple absorption-elution tests and titer integral method.RHCE and JK gene were sequenced by multiple PCR.Results Serological gene sequencing analysis showed that the ABO blood group of the patient was A type with Rh subtype ccDEE and was posi-tive for direct antiglobulin test(DAT).Multiple absorption-elution tests and titer integral method demonstrated that the ser-um of the patient contained anti-C,e alloantibodies along with anti-e,Jkb mimicking autoantibodies and there were anti-e,Jkb mimicking autoantibodies on red blood cells(RBCs).According to gene sequencing analysis,there was G>C at exon 676 of the RHCE gene,and the remaining exons were not mutated,suggesting that the RHCE phenotype was ccEE.The 838 G/A heterozygote of exon 9 in JK gene,Jk blood group phenotype was Jk(a+b+).Cross matched type A ccDEE and Jk(a+b-)RBCs were transfused,and no adverse reactions occurred.Conclusion Serology combined with molecular biology to i-dentify the phenotype of the patient's RBCs,absorption-elution test and titer integral method to identify the antibody of the patient's serum can detect the alloantibody type,thus providing strategies for targeted blood transfusion.

关键词

抗体筛查/类同种抗体/吸收放散/基因检测

Key words

antibody screening/mimicking alloantibody/absorption-elution/genetic testing

引用本文复制引用

基金项目

江苏省英科新创科研基金课题(JSYK2023018)

常州市中心血站站级课题(XZ202305)

出版年

2024
中国输血杂志
中国输血协会 中国医学科学院输血研究所

中国输血杂志

CSTPCD
影响因子:1.279
ISSN:1004-549X
参考文献量17
段落导航相关论文