Plasma exchange for cold agglutinin hemolytic anemia

Taft, Edwin G.; Propp, Richard P.; Sullivan, A B S Susan

doi:10.1046/j.1537-2995.1977.17277151925.x

Cited by 46 publications

(8 citation statements)

References 7 publications

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“…We have not treated our patient so far because her symptoms are relatively mild, but plasmapheresis and continuous-flow centrifugation (Taft et al, 1977) and chlorambucil treatment may have to be considered. There is no evidence of lymphoma or other malignant disease in this patient.…”

Section: Discussionmentioning

confidence: 99%

Anti blood group-M autoantibodies with livedo reticularis, Raynaud's phenomenon, and anaemia.

Sangster¹,

Kenwright²,

Walker³

et al. 1979

J Clin Pathol

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SUMMARY A 63-year-old woman presented with Raynaud's phenomenon and extensive cold-induced livedo reticularis. A skin biopsy showed no abnormality of the blood vessels but the blood contained high titres of a very unusual autoantibody against the M blood group, most active at low temperatures. An IgM cryoglobulin was detected, and anti-M activity was found in this fraction. Livedo reticularis may occur in a wide variety of diseases affecting the blood vessels of the skin or the theological properties of the blood (Champion, 1965;Copeman, 1975). We describe the case of a woman with Raynaud's phenomenon and severe and extensive livedo reticularis regularly induced by cold and abolished by warmth, in whom the only abnormality found was an unusual anti-M autoantibody most active at low temperatures. Case historyA 63-year-old housewife was admitted to The London Hospital in May 1977 complaining of purplish discoloration of the limbs. Ten months before admission she developed severe intermittent cramping pain in the upper arms, which was worse at night; this lasted for about three months and then resolved. At about the same time as the pain she noticed purple mottling especially of the hands but also of the arms and legs. This was worse in the cold and disappeared completely when she was very warm. For six months before admission she had noticed Raynaud's phenomenon affecting the hands. Prednisolone, 10 mg daily, had been given for some weeks without benefit. She had had tuberculosis of the spine and rheumatic fever as a girl. She had had two miscarriages, and two live births with healthy infants. She had never had a blood transfusion. For some years before admission INVESTIGATIONSHaemoglobin 9.5 g/dl, haematocrit 0-291, mean corpuscular volume 92 fl, mean corpuscular haemoglobin 30-3 pg, mean corpuscular haemoglobin concentration 32-4 g/dl. Anisocytosis, polychromasia, and agglutination of the red cells were noted, but unfortunately a reticulocyte count was not performed. The blood count was repeated three months later in warm weather and showed a haemoglobin of 12-8 g/dl and a reticulocyte count of 1-2 %. The white cells and platelets were normal. Serum total bilirubin 28 ,tmol/l (1 -6 mg/100 ml) direct 5 ,umol/l (0-3 mg/ 100 ml), liver function tests otherwise normal. A biopsy of affected skin showed no abnormality on histological or immunofluorescent examination; the blood vessels were normal. The following were also normal or negative: antinuclear factor and autoantibody screen, latex fixation test, plasma protein electrophoresis, serum iron, vitamin B12 and folate, red-cell folate, urea and electrolytes, Treponema pallidum, haemagglutination, and VDRL slide test, microscopy and culture of the urine, and x-rays of the chest, skull, and hands. X-ray of the lumbar 154 on 10 May 2018 by guest. Protected by copyright.

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Section: Discussionmentioning

confidence: 99%

Anti blood group-M autoantibodies with livedo reticularis, Raynaud's phenomenon, and anaemia.

Sangster¹,

Kenwright²,

Walker³

et al. 1979

J Clin Pathol

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“…We therefore examined the 1 activities of the ovarian cyst mucins with a number of anti-1 sera [3,4,8]. We received anti-I Ba and By from two patients undergoing plasma exchange for cold agglutinin disease [27], from Dr. Edwin Taft, two high titered monoclonal anti-I sera from George Garratty, two monoclonal anti-I sera from Dr. DonaldBaker of ChemBiomed, Alberta, Canada, anti-i Den (described in a study by Pruzanski [28]) from Mary Crookston, four anti-1 sera through a Serum Cell and Rare Fluids (SCARF) exchange program, and the well characterized anti-I (Ma) from Ten Feizi [29,30]. Six anti-I sera, including the anti-1 (Hy), were collected in our own institution.…”

Section: Ovarian Cyst Mucin Oligosaccharidesmentioning

confidence: 99%

The structural relationship of blood group-related oligosaccharides in human carcinoma to biological function: A perspective

Dube

1987

Cancer Metast Rev

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Blood group-related oligosaccharides have been isolated from a limited number of carcinomas. The carcinoma-associated oligosaccharides show chain elongation, for example due to repeating Gal 1,4 GlcNAc 1,3 sequences, or a higher degree of branching, which permit increased sialylation and fucosylation. Abnormal carbohydrate structures have been demonstrated on tumor cell membranes by immunological techniques, which suggests deletion of ABH, accumulation of 'crypt' antigens such as I and T antigens, and abnormal expression of Lewis antigens. Changes in carcinoma-associated oligosaccharides can result from altered biosynthetic processing in the Golgi apparatus or the occurrence of abnormal tumor glycosyltransferase isoenzymes. Structural alterations of oligosaccharides on the tumor cell membrane are related to the regulation of tumor growth, cell-cell interaction, cell differentiation, and metastasis. Glycoproteins secreted by tumor cells into the circulation evoke cellular and humoral immunity and cause immune suppression by binding to cytotoxic T lymphocytes and lymphocyte subsets. The relationship of oligosaccharide structures to biologic function awaits elucidation.

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“…Indeed, the patient had been at first treated with peritoneal dialysis to avoid the prospective trouble of hemodialysis however, the serum titers of cold agglutination were reduced markedly with no symptoms. But specific treatment such as plasmapher esis or immunoabsorption is necessary when the agglut inin is the warm antibody [14].…”

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confidence: 99%

A Case of Chronic Renal Failure Followed by Cold Agglutinin Due to <i>Mycoplasma pneumoniae</i>Infection

Shibasaki¹,

Gomi²,

Ohno³

et al. 1991

Nephron

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Plasma exchange for cold agglutinin hemolytic anemia

Cited by 46 publications

References 7 publications

Anti blood group-M autoantibodies with livedo reticularis, Raynaud's phenomenon, and anaemia.

Anti blood group-M autoantibodies with livedo reticularis, Raynaud's phenomenon, and anaemia.

The structural relationship of blood group-related oligosaccharides in human carcinoma to biological function: A perspective

A Case of Chronic Renal Failure Followed by Cold Agglutinin Due to <i>Mycoplasma pneumoniae</i>Infection

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