Characterization of autoantibodies in mixed-type autoimmune hemolytic anemia

Vox Sang. 1991;60(1):45-52. doi: 10.1111/j.1423-0410.1991.tb00870.x.

Abstract

Three of 46 patients with autoimmune hemolytic anemia (AIHA) satisfied the diagnostic criteria for mixed-type AIHA in which both warm-type and cold-type autoantibodies against red blood cells (RBCs) are present. The specificities of these autoantibodies were analyzed. All of the warm-type autoantibodies were IgG-chi, and the specificities were not serologically classified. The autoantibody of patient 1 reacted to the 41- and 80-kD peptides on immunoblotting, and the epitope corresponding to it was papain sensitive. Two warm-type autoantibodies from patients 2 and 3 resembled each other in serological analyses and reacted with a protease- and neuraminidase-resistant antigen. However, the antigen corresponding to the autoantibody of patient 3 was located on the 37-kD peptide by immunoprecipitation. All of the cold-type autoantibodies were IgM-cha and showed high titer and high thermal amplitude. According to the reaction pattern with untreated and enzyme-treated RBCs, the cold-type autoantibodies of patients 2 and 3 were revealed to be anti-Om and anti-I, respectively. In patient 1, the cold-type autoantibody was characterized as having high affinity for autologous RBCs, but its specificity was unclassified. The antigens corresponding to the cold-type autoantibodies were not located by immunoblotting and immunoprecipitation. These serological and immunochemical approaches to autoantibodies in mixed-type AIHA revealed that the warm and cold components recognized the different antigens.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anemia, Hemolytic, Autoimmune / etiology
  • Anemia, Hemolytic, Autoimmune / immunology*
  • Antibodies, Anti-Idiotypic / immunology*
  • Antibodies, Anti-Idiotypic / isolation & purification
  • Autoantibodies / immunology*
  • Autoantibodies / isolation & purification
  • Coombs Test
  • Cryoglobulins / immunology*
  • Cryoglobulins / isolation & purification
  • Erythrocyte Membrane / immunology
  • Female
  • Humans
  • Immunoglobulin G / immunology*
  • Immunoglobulin M / immunology*
  • Immunoglobulin kappa-Chains / immunology
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications
  • Temperature

Substances

  • Antibodies, Anti-Idiotypic
  • Autoantibodies
  • Cryoglobulins
  • Immunoglobulin G
  • Immunoglobulin M
  • Immunoglobulin kappa-Chains