The intention to replace polyclonal IgG anti-D with human monoclonal antibody in the prophylaxis of haemolytic disease of the newborn requires knowledge concerning the relative content of IgG1 and IgG3 anti-D in prophylactic IgG preparations that are in present use. This has been carried out using a functional assay in which the absolute amount of IgG1 and IgG3 anti-D present on red cells was determined after incubation with IgG preparations. The assay was carried out by flow cytometry on 17 samples; expressed as a percentage of the total, the average value for the amount of IgG3 anti-D on the cells was 8% (range 1-18%). Similar measurements were also made on the anti-D present in 18 samples of antisera; IgG3 anti-D formed a larger fraction of the total, the average value being 17% (range 0-60%) confirming previously reported estimates. It is suggested that some of the low values found for IgG3 in IgG preparations may be due do preferential loss during production.
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Prevention of Maternal Rh D Alloimmunization: A Comparative Review of Guidelines.
Obstet Gynecol Surv
December 2024
Associate Professor.
Importance: Rhesus alloimmunization refers to the sensitization of an Rh D-negative mother after exposure to D-positive fetal red blood cells, which can lead to significant fetal and neonatal morbidity and mortality.
Objective: The aim of this study was to review and compare the most recently published international guidelines on the prevention of maternal alloimmunization.
Evidence Acquisition: A comparative review of guidelines from the American College of Obstetricians and Gynecologists, the British Committee for Standards in Hematology, the International Federation of Gynecology and Obstetrics, the Royal Australian and New Zealand College of Obstetricians and Gynecologists, and the Society of Obstetricians and Gynecologists of Canada regarding the prevention of maternal Rh D alloimmunization was conducted.
Variations and Opportunities in Postnatal Management of Hemolytic Disease of the Fetus and Newborn.
JAMA Netw Open
January 2025
Division of Neonatology, Department of Pediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, the Netherlands.
Importance: Preventive efforts in pregnancy-related alloimmunization have considerably decreased the prevalence of hemolytic disease of the fetus and newborn (HDFN). International studies are therefore essential to obtain a deeper understanding of the postnatal management and outcomes of HDFN. Taken together with numerous treatment options, large practice variations among centers may exist.
View Article and Find Full Text PDFA new way of the Coombs test using flow cytometry-based assay to assess erythrocytes-bound IgG antibodies in the human and rabbit model.
Int J Immunopathol Pharmacol
January 2025
College of Medical Laboratory, Dalian Medical University, Dalian, Liaoning, China.
The Coombs test is important in hematology for detecting erythrocyte-bound IgG antibodies or in serm through agglutination methods, but its sensitivity and specificity are limited. Flow cytometry provides a more precise and sensitive alternative for quantitatively assessing RBC-bound IgG antibodies. This assessment is crucial for evaluating the risk of hemolytic reactions and ensuring safe transfusions.
View Article and Find Full Text PDF[Study on the Production of Anti-D and Anti-E Mixed Antibodies by Alloimmunization in RhD Variant Type33 Recipients].
Zhongguo Shi Yan Xue Ye Xue Za Zhi
December 2024
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Objective: To investigate the cause of the production of anti-D and anti-E mixed antibody in an RhD positive patient.
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Anti-G evaluations in D- pregnant women determine the need for Rh immune globulin prophylaxis: report of two illustrative cases.
Immunohematology
December 2024
Department of Pathology, University of Wisconsin Hospital, Madison, WI.
Distinguishing anti-D, anti- C, and anti-G specificities is particularly essential in antenatal cases to ensure proper patient management. The clinical management as well as Rh immune globulin (RhIG) prophylaxis depend on the accurate identification of these distinct antibodies. D- pregnant women with anti-G, but without anti-D, in their serum need RhIG prophylaxis at 28 weeks of gestation, at delivery if the infant is D+, and when clinically indicated to prevent the formation of anti-D and potential hemolytic disease of the fetus and newborn (HDFN).
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