RARE ANTI-RED CELL ANTIBODIES RELATED WITH INFECTIOUS DISEASES Anti-Pra Following Rubella Infection and Anti-H Along with Bacterial Pneumonia

• Published in: Journal of the Japan Society of Blood Transfusion Vol. 38; no. 1; pp. 75 - 81
• Main Authors: Ishida, Tomoko, Okubo, Susumu, Yasunaga, Kojiro, Miyamoto, Atsuko, Fujinami, Shigeru, Inoue, Kyoichi, Kadota, Yohichi
• Format: Journal Article
• Language: Japanese
• Published: The Japan Society of Transfusion Medicine and Cell Therapy 1992
• ISSN: 0546-1448; 1883-8383
• DOI: 10.3925/jjtc1958.38.75

Case No. 1: A 24-year-old man, complaining of fever, skin eruption, jaundice, brown urine and lymphnodes swelling, had hemolytic anemia caused by cold agglutinin following rubella infection. Laboratory tests revealed low Hb (4.6g/dl), high GOT (60U/L), LDH (2050U/L), T-bilirubin (bil) (7.4mg/dl), D-bil (1.7mg/dl), and high cold agglutinin titer (over×2048), undetectable amount of haptoglobin, and elevated anti-rubella antibody (IgM-c×6.64). Because the cold agglutinin of the patient strongly reacted against a group O red blood cell (RBC), O umbilical RBC, O adult i RBC and neuraminidase treated RBC, and weakly against enzyme (papain, ficin, bromelin) treated RBC, it was identified as anti-Pra. Glucocorticoid administration of the patient improved his clinical and laboratory findings. Case No. 2: A 44-year-old male patient of malignant lymphoma, blood group A1, Rh-positive, suffered from S. pneumonia. He had never received blood transfusion. Laboratory tests revealed anti-H, composed of IgG (IgG1, IgG2) and IgM, the titer being 1:64 by the saline method at room temperature, 1:4 by the albumin method at 37°C, and 1:32 by the antiglobulin method. The antibody titer fell to 1:1 along with remission of the pneumonia. These cases suggest viral or bacterial infections may induce some anti-RBC antibodies.