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Broome CM. Diagnosis and treatment of cold agglutinin disease. Clin Adv Hematol Oncol 2019; 17:162-165. [PMID: 30969954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Catherine M Broome
- MedStar Georgetown University Hospital, Georgetown Lombardi Comprehensive Cancer Center, Washington, DC
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2
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Weldy L. Polyethylene glycol antiglobulin test (PEG-AGT). Immunohematology 2014; 30:158-160. [PMID: 25831263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Polyethylene glycol (PEG) ws described in 1987 as a new technique for immunohematology testing. The original paper described its use in detection and identification of weakly reactive antibodies. PEG is used as an additive to enhance reactivity and to reduce incubation time when testing for unexpected antibodies. PEG can be used as an alternative to low-ionic-strength saline and whenever weak reactions are encountered.
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Affiliation(s)
- Larry Weldy
- MT(ASCP)SBB, Supervisor, IRL, American Red Cross, Lewis and Clark Region, 6616 South 900 East, Salt Lake City, UT 84121
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3
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Alişkan H, Colakoğlu S, Turunç T, Demiroğlu YZ, Yazic AC, Arslan H. [Evaluation of diagnostic value of Brucellacapt test in brucellosis]. MIKROBIYOL BUL 2007; 41:591-595. [PMID: 18173079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Although standard tube agglutination (STA) test is the most preferred method for the serodiagnosis of brucellosis, it may yield false negative results because of its incompetence in detecting the blocking (non-agglutinating) antibodies. Blocking antibodies can be detected by Coombs' test (anti-human globulin test), which is generally not performed in laboratories routinely since it is a time consuming and laborious method. Recently more practical Brucellacapt (immunocapture-agglutination) test is being used for the detection of total antibodies without any interference of the presence of blocking ones. The aim of this study was the evaluation of the value of Brucellacapt test in the serodiagnosis of brucellosis. Twenty-five brusellosis patients whose blood cultures yielded Brucella melitensis growth, and 31 healthy subjects as controls, were included to the study. Serum samples obtained from all of the 56 subjects have been searched by STA, Coombs' and Brucellacapt methods, and threshold titre was accepted as 1/160. As a result, 40% (10/25) of culture positive patients were found positive (> or =1/160) by STA, whereas 92% (23/25) were positive (> or =1/160) by both Coombs' and Brucellacapt tests. No positivity was detected in the control group by any one of those three tests. The agreement between Coombs and Brucellacapt methods was found as 100%, while the sensitivity and specificity of Brucellacapt test were estimated as 92% (23/25) and 100% (31/31), respectively, when the culture was accepted as reference method. Although our data have pointed out the high performance of Brucellacapt test in brusellosis serodiagnosis, confirmation with further data carried on extensive and comprehensive study groups, are needed.
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Affiliation(s)
- Hikmet Alişkan
- Başkent Universitesi Tip Fakültesi, Mikrobiyoloji ve Klinik Mikrobiyoloji Anabilim Dali, Ankara.
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4
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Weisbach V, Kohnhäuser T, Zimmermann R, Ringwald J, Strasser E, Zingsem J, Eckstein R. Comparison of the performance of microtube column systems and solid-phase systems and the tube low-ionic-strength solution additive indirect antiglobulin test in the detection of red cell alloantibodies. Transfus Med 2006; 16:276-84. [PMID: 16879156 DOI: 10.1111/j.1365-3148.2006.00674.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
To compare the performance of seven currently available test systems in the detection of erythrocyte alloantibodies (ab), we tested in parallel 446 sera samples containing red cell ab [368 sera samples with ab that are assumed to be clinically significant (cs-ab) and 78 sera samples with ab that are assumed to be of minor clinical significance (ms-ab)] using the tube spin low-ionic-strength solution (addition method) indirect antiglobulin test (tube LISS-IAT), three microtube column agglutination techniques (DiaMed-ID, Ortho BioVue and Bio-Rad Scangel), one affinity adherence test system (CLB/Mast CellBind Screen) and two solid-phase tests [Biotest Solidscreen II and Immucor Capture-R Ready-Screen (4)]. To address the specificity of the three test systems under routine conditions, results of 4566 patient samples obtained using the tube LISS-IAT, results of 5205 patient samples obtained using the Scangel and results of 3560 samples obtained using the Capture-R were evaluated. The DiaMed-ID detected 344 cs-ab and 43 ms-ab, BioVue 333 cs-ab and 48 ms-ab, Scangel 348 cs-ab and 62 ms-ab, CellBind Screen 346 cs-ab and 47 ms-ab, Solidscreen 330 cs-ab and 38 ms-ab, Capture-R 358 cs-ab and 45 ms-ab and LISS-IAT 159 cs-ab and 12 ms-ab. In routine practice, erythrocyte cs-ab could be identified in 61 (67.8%) of 90 reactive sera (specificity: 98.6%) in the tube LISS-IAT, in 169 (58.7%) of 288 (94.4%) in Bio-Rad Scangel and in 101 (51.0%) of 198 reactive sera (94.3%) in Capture-R. We conclude that the sensitivity of the microcolumn, affinity adherence and solid-phase test systems in the detection of cs-ab was similar and was markedly superior to that of the conventional tube LISS-IAT. All high-sensitive test systems produced higher rates of false positives and ms-ab compared to the tube test. An individual cost-benefit analysis, considering the recent knowledge about the clinical significance of weak-reactive cs-ab, should be performed in every institution to decide whether and if so which high-sensitive screening system should be applied.
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Affiliation(s)
- V Weisbach
- Department of Transfusion Medicine and Hemostaseology, Friedrich-Alexander-University Erlangen - Nürnberg, Erlangen, Federal Republic of Germany.
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Melo L, Pellegrino J, Bianco C, Castilho L. Twelve years of the Brazilian External Quality Assessment Program in Immunohematology: benefits of the program. J Clin Lab Anal 2005; 19:209-18. [PMID: 16170810 PMCID: PMC6808094 DOI: 10.1002/jcla.20080] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The Brazilian External Quality Assessment Program in Immunohematology (BEQAPI) was introduced with the objective of evaluating the quality of diagnosis in immunohematology. From 1992 to 2003, proficiency tests for ABO grouping, Rh (D, C, c, E, e), K phenotyping, direct antiglobulin testing (DAT), antibody screening (AS), and antibody identification (AI) were performed. A total of 41 evaluations were carried out in 223 institutions. Over the period of 12 years, the program included 8,014 ABO typing, 8,000 RhD typing, 5,193 Rh typing (C, c, E, e), 5,101 K phenotyping, 7,939 AS, 4,533 AI, and 7,912 DATs. Erroneous responses were classified as clerical, technical, or undetermined. A substantial proportion of erroneous responses due to clerical errors occurred in ABO typing (76/76 errors), RhD typing (34/58 errors), and Rh phenotyping (50/73 errors). Technical errors occurred predominantly for weak D (91/95 errors), AS (252/301 errors), and AI (321/335 errors). Based on these results, since 1996, participants have received "Questions and Case Studies" in Immunohematology as an incentive for training and education. The results of the present study show an improvement in the performance of participants in the course of the program. We found that a well-organized external proficiency program can contribute to the improvement of quality of testing in Immunohematology.
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Arndt PA, Leger RM, Garratty G. Positive direct antiglobulin tests and haemolytic anaemia following therapy with the beta-lactamase inhibitor, tazobactam, may also be associated with non-immunologic adsorption of protein onto red blood cells. Vox Sang 2003; 85:53. [PMID: 12823734 DOI: 10.1046/j.1423-0410.2003.00323.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abou-Jabal A, Shubeilat T, Hajjiri F. Evaluation of 2-column agglutination versus conventional tube technique for antibody screening. East Mediterr Health J 2003; 9:407-12. [PMID: 15751934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
The study aimed to determine the specificity and sensitivity of the Ortho BioVue two-column agglutination system for the detection of low concentrations of clinically significant antibodies in serum. The BioVue system was compared with the conventional tube technique (LISS-Coombs indirect antiglobulin test), and the two-stage Papenzyme test was used to resolve discrepancies between the two methods. We tested 3000 serum samples from randomly selected patients at King Hussein Medical Centre. Both the antibody screening and identification gave negative results in 2952 patients and positive results in 48 patients. We found the BioVue system to be the more sensitive technique. However, if papain enzyme-treated cells were included in the conventional tube technique when applied to antibody screening and identification, both methods would be of comparable sensitivity.
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Affiliation(s)
- A Abou-Jabal
- Blood Transfusion Service, King Hussein Medical Centre, Amman, Jordan
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8
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Abstract
Auto-immune haemolytic anaemia (AIHA) is characterised by haemolysis associated with the presence of the immunoglobulins IgG, IgM or IgA, and/or components of the complement system on the red cell membrane. The immunoglobulins react as auto-antibodies against the red cell antigens of the patient. IgG antibodies and the complement component C3d can be detected by the direct antiglobulin test (DAT); however, IgM and particularly IgA antibodies may not necessarily be detected by the broad-spectrum anti-human-globulin serum. We present the case of a 48-yr-old woman with severe AIHA. The initial polyspecific direct antiglobulin test (DAT), using a broad-spectrum antiserum, was negative. Testing with monospecific antisera led to the diagnosis of AIHA due to warm-acting auto-antibodies solely of the IgA class, which is a very rare finding. As therapy with steroids alone did not lead to a lasting remission, splenectomy was performed 10 months after initial diagnosis. There has been no relapse of AIHA since, even after steroid medication was withdrawn and even though the monospecific IgA-DAT has remained positive. This case demonstrates the importance of performing a monospecific antiglobulin test if there is a strong suspicion of AIHA in apparently "Coombs-negative" haemolytic anaemia. In AIHA caused by solely IgA antibodies, the polyspecific direct antiglobulin test may be negative or only weakly positive because of a limited content of anti-IgA antibodies in the polyspecific anti-human-globulin serum. First-line treatment of warm-type AIHA is the administration of high-dose glucocorticosteroids; splenectomy is indicated in steroid-refractory patients.
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Affiliation(s)
- B Bardill
- Department of Internal Medicine, Kantonsspital, CH-6000 Lucerne 16, Switzerland
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9
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Bohring C, Krause W. Interlaboratory variability of the indirect mixed antiglobulin reaction in the assessment of antisperm antibodies. Fertil Steril 2002; 78:1336-8. [PMID: 12477539 DOI: 10.1016/s0015-0282(02)04282-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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10
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Voak D, Knowles SM, Milkins CE, Chapman JS, Scott M. The major factors and weak links that must be considered to achieve safety in compatability testing. Vox Sang 2002; 83 Suppl 1:327-32. [PMID: 12617163 DOI: 10.1111/j.1423-0410.2002.tb05328.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Llopis F, Carbonell-Uberos F, Montero MC, Terrón I. Standardization of anti-human globulin sera for phenotyping red blood cells using a new method. Vox Sang 2002; 82:52. [PMID: 11856471 DOI: 10.1046/j.0042-9007.2001.00126.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Wang Z, Shi J, Zhou Y, Ruan C. Detection of Red Blood Cell—Bound Immunoglobulin G by Flow Cytometry and its Application in the Diagnosis of Autoimmune Hemolytic Anemia. Int J Hematol 2001; 73:188-93. [PMID: 11372730 DOI: 10.1007/bf02981936] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Detection of autoantibodies to erythrocytes is of fundamental importance in the diagnosis of autoimmune hemolytic anemia (AIHA). The routinely used direct antiglobulin test (DAT) has the disadvantage of low sensitivity. In this study, we investigated the optimal test conditions of measurement of red blood cell (RBC)-bound immunoglobulin (Ig) G by flow cytometry (FCM). We studied 64 patients with AIHA, 30 anemic patients diagnosed with other diseases, and 36 healthy individuals. In 33 AIHA patients who were found to have RBC-bound IgG, both the mean fluorescence intensity (MFI) and percentage of fluorescence-activated RBCs were remarkably increased and results of both were considered positive. In the remaining 31 AIHA patients who had positive results for RBC-bound complement C3d, the MFI and the percentage of fluorescence-activated RBCs was also increased and 17 patients (54.8%) were considered to have a positive result by this method. In anemic patients with negative DATs the results of FCM were always negative. These results could be confirmed by enzyme-linked immunosorbent assay (ELISA), and the values obtained by FCM and ELISA corresponded to titration scores of the DAT. Additionally, in 3 of the other 8 patients who were suspected to have DAT-negative AIHA, RBC-bound IgG was detected by FCM and ELISA. Our investigation demonstrates that FCM is a precise, reliable, and sensitive method of detecting RBC-bound autoantibodies and could be used as a new routine diagnostic technique for AIHA and other immune hemolytic anemias.
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Affiliation(s)
- Z Wang
- Jiangsu Institute of Hematology, The First Affiliated Hospital of Suzhou University, People's Republic of China.
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13
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Revision to requirements for licensed Anti-Human Globulin and Blood Grouping Reagents. Food and Drug Administration, HHS. Direct final rule. Fed Regist 2000; 65:77497-9. [PMID: 11503726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
The Food and Drug Administration (FDA) is amending the biologics regulations applicable to microbiological controls for licensed Anti-Human Globulin (AHG) and Blood Grouping Reagents (BGR). FDA is amending the regulations to remove the requirements that the products be sterile. FDA is publishing this direct final rule because the requirement that these products be sterile is not necessary for the products to be safe, pure, and potent. FDA is issuing these amendments directly as a final rule because they are noncontroversial and there is little likelihood that FDA will receive any significant comments opposing the rule. Elsewhere in this issue of the Federal Register, FDA is publishing a proposed rule under FDA's usual procedures for notice and comment in the event the agency receives any significant adverse comments. If FDA receives any significant adverse comment that warrants terminating the direct final rule, FDA will consider such comments on the proposed rule in developing the final rule.
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Abstract
The past year's literature shows that little progress has been achieved in the laboratory diagnosis of autoimmune hemolytic anemia. The direct antiglobulin test is the only diagnostic test for autoimmune hemolytic anemia. Advantages of new techniques, such as the gel test, have to be determined. Today, cephalosporins are known to cause both drug-dependent and -independent autoantibodies. The diagnosis of idiopathic thrombocytopenic purpura is a clinical one. The new assays that measure antibodies against specific glycoproteins offer improved specificity. New laboratory advancements and accumulation of data on granulocytes' antigens and antibodies enabled us to recommend guidelines for the laboratory investigation of autoimmune neutropenia.
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Affiliation(s)
- N Manny
- Blood Bank and Transfusion Medicine Department, Hadassah Medical Organization, Kiryat Hadassah, Jerusalem, Israel.
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15
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Abstract
OBJECTIVES Antibodies of different immunoglobulin isotypes, or complement, may coat red blood cells in vivo. They are detected by the direct antiglobulin test (DAT), usually performed by the conventional tube technique. The purpose of this study was to compare the latter technique with the gel test. METHODS Three hundred and ninety-eight consecutive samples, sent to our laboratory for direct antiglobulin testing, were analyzed with the tube technique and the gel test, using reagents from different manufacturers. Eighty-seven samples had been collected from newborns and 23 from fetuses. Results were expressed as positive or negative. RESULTS In 162 out of 398 cases, the DAT was negative with both methods, whereas in 178 out of 398 cases, the DAT was positive with both techniques using polyspecific antibodies (observed agreement: 84.5%; kappa = 0.71). Discrepancies between the two methods were observed in 58 cases: 51 samples appeared as DAT positive using the tube method and negative with the gel test, whereas only 7 were positive exclusively with the gel test. Among the 178 samples that were positive with both techniques, 93 samples showed discordant results when evaluated with monospecific antisera (11 with anti-IgG and 82 with anti-C3d, respectively). The sensitivity of the DAT performed by the gel test, in comparison with the conventional tube technique, was 75.4% (95% confidence interval (CI): 69.4-80.8). 96. 8% (95% CI: 92.8-99.0), and 16.3% (95% CI: 9.8-24.9) with polyspecific, anti-IgG and anti-Cd3 reagents, respectively. CONCLUSIONS The gel test appeared to be less sensitive than the conventional tube technique when utilized for DAT, particularly when C3d was present on red blood cells. These results emphasize that before implementing a new technique in the laboratory, comparison with existing techniques, using different reagents, is mandatory.
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Affiliation(s)
- J D Tissot
- Service régional vaudois de transfusion sanguine; Unité d'évaluation des soins, Hospices cantonaux, Lausanne, Suisse.
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Abad A, López P, Bauza J. Norfloxacin-induced positive direct antiglobulin test. Vox Sang 2000; 77:238. [PMID: 10717605 DOI: 10.1159/000031134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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17
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Dabdoob WA, Abdulla ZA. A panel of eight tests in the serodiagnosis and immunological evaluation of acute brucellosis. East Mediterr Health J 2000; 6:304-12. [PMID: 11556017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
A panel of eight tests was used to study 200 cases of acute brucellosis, 200 patients negative for brucella as a control group and 200 apparently healthy individuals as a second control group. The best diagnostic test was the rose Bengal test using an imported reagent (BioMérieux, France) and 2 local reagents. This test was improved from being a screening test to be a titrable one. The best two tests used together were the tube agglutination test with Coomb-like test. The indirect fluorescent antibody test had no advantages over the use of other tests. The 2-mercaptoethanol test and C-reactive protein test were useful in checking the brucellosis activity. Normal numbers of E-rosette forming cells and inefficient neutrophils in phagocytosis were found in peripheral blood during acute brucellosis.
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Affiliation(s)
- W A Dabdoob
- Department of Microbiology, College of Medicine, University of Mosul, Mosul, Iraq
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18
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Abstract
The test most commonly used to detect sperm antibodies is the mixed antiglobulin reaction (MAR), standardized by the World Health Organization. The indirect MAR test detects soluble sperm antibodies in seminal plasma by using healthy donor spermatozoa as antigen. In this study we systematically investigated the influence of donor spermatozoa and the source of sperm antibodies upon the results of the indirect MAR test, and calculated the intra- and inter-assay variations. Using one individual seminal plasma and the same donor semen, results of the indirect MAR test are highly reproducible (low intra-assay variation). Two dimensions of inter-assay variation must be considered: (i) serial ejaculates of an individual donor may be used at different times; (ii) different donors may be applied to identical antibody sources. Donor spermatozoa strongly influenced the results of the indirect MAR test. Using multivariate statistical tests, highly significant main effects between the different donors (P < 0.001) and specific reciprocal effects between donor spermatozoa and seminal plasma samples (P < 0.001) were observed. The high inter-assay variation of the indirect MAR test will lead to incorrect results. There is urgent need of a reliable and reproducible test for sperm antibody detection to improve quality control of the methods.
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Affiliation(s)
- C Bohring
- Clinic of Dermatology, Department of Andrology, Clinical Training Center of the European Academy of Andrology, Philipp University, Deutschhausstrabetae 9, D-35033 Marburg, Germany
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Phillips P, Voak D, Downie M, Clark N, Miguta J, Rawlings J, Patel B, Redman M. New reference reagent for the quality assurance of anti-D antibody detection. Transfus Med 1998; 8:225-30. [PMID: 9800296 DOI: 10.1046/j.1365-3148.1998.00153.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A UK BTS-NIBSC freeze-dried anti-D preparation has been prepared and used to monitor the performance of routine antibody detection tests and of the test operators. With the day-to-day use of this preparation, adverse changes in test performance and in test operator may be detected and appropriate action taken before the effect becomes significant. Two dilutions of this preparation have been defined, one which should be detected unequivocally in every test; the other, more dilute, may not be detected in every test but is used to monitor changes in performance. Experience with the use of this preparation is reported from three test centres undertaking routine antibody detection tests. By monitoring results over a series of working days, significant differences were noted in operator performance within one test centre, as was a reduced sensitivity of a given test system within one test centre compared with the same system in the other test centres. These differences were detected only by monitoring the results obtained with this preparation.
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Affiliation(s)
- P Phillips
- National Institute for Biological Standards and Control (NIBSC), Potters Bar, UK
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20
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Devignes J, Le Pennec PY, Gien D, Mannessier L, Rouger P. [The direct antiglobulin and elution tests: evaluation of quality control in Blood Transfusion Centers]. Transfus Clin Biol 1996; 3:241-6. [PMID: 8983517 DOI: 10.1016/s1246-7820(96)80003-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The Société Française de Transfusion Sanguine and the Centre National de Référence pour les Groupes Sanguins performed a quality control to evaluate the performances of two serological tests: the Direct Antiglobulin Test (DAT) and the Elution test. Among the 110 Blood Transfusion Centers participating in this control, 80 (73%) returned a result. Of these, 68 results were correct for the DAT (85%; positive for type IgG) and 31 results were correct for the elution (39%; anti-FY1). This control gave the opportunity to confirm the main procedures used in routine testing on a national scale. The analysis of the results underlines the importance of the choice of a standardized technique for these tests. Such controls are useful to appreciate the quality of the routine tests and to find the means to improve them.
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Affiliation(s)
- J Devignes
- Centre National de Référence pour les Groupes Sanguins, Paris
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21
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Scott ML, Voak D, Phillips PK, Hoppe PA, Kochman SA. Review of the problems involved in using enzymes in blood group serology--provision of freeze-dried ICSH/ISBT protease enzyme and anti-D reference standards. International Council for Standardization in Haematology. International Society of Blood Transfusion. Vox Sang 1994; 67:89-98. [PMID: 7975466 DOI: 10.1111/j.1423-0410.1994.tb05051.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Proteolytic enzyme preparations and techniques used routinely in blood group serology for the detection of atypical patient antibodies prior to transfusion vary widely and are often poorly standardised. Recent advances have been made in the use of biochemical methods to standardise and stabilise the potency of the enzyme preparations used. A joint working party of the International Council for Standardization in Haematology (ICSH) and the International Society of Blood Transfusion (ISBT) has investigated possibilities for the provision of standards for the protease preparations and techniques. The specification for these standards was that the performance of enzyme reference preparation in the reference technique should be of equivalent sensitivity to the ICSH/ISBT LISS spin indirect antiglobulin test using a titration series of a reference weak anti-D, and be free from false-positive reactions. The working party circulated materials for evaluation in inter-laboratory trials, followed by a laboratory workshop meeting to achieve agreement on the specification for reference materials and methods. Reference freeze-dried papain at 0.6 azoalbumin units and weak anti-D preparations (91/562) have been prepared and validated to meet these specifications. The performance of a test enzyme preparation in the technique for which it is recommended for use should be at least equal to that of the reference papain preparation, by the reference two-stage technique in terms of sensitivity, using a titration series of the reference anti-D, and freedom from false-positive reactions, using six fresh inert sera. The reference papain and weak anti-D can also be used to calibrate the level of proteolytic activity required in other procedures in blood group serology, such as new technology methods for antibody detection, and automated and microplate cell grouping procedures. These preparations and an agreed method for their use are now available from listed centres as ICSH/ISBT and Food and Drug Administration reference materials.
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Affiliation(s)
- M L Scott
- International Blood Group Reference Laboratory, Bristol, UK
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22
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Phillips PK, Voak D, Whitton CM, Downie DM, Bebbington C, Campbell J. BCSH-NIBSC anti-D reference reagent for antiglobulin tests: the in-house assessment of red cell washing centrifuges and of operator variability in the detection of weak, macroscopic agglutination. British Committee for Standards in Haematology. National Institute for Biological Standards and Control. Transfus Med 1993; 3:143-8. [PMID: 8397043 DOI: 10.1111/j.1365-3148.1993.tb00052.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
A batch of an anti-D preparation, reference 91/608, has been prepared for the preparation of red cells weakly sensitized with IgG that can reveal inhibition of the antiglobulin test by one volume of human serum, diluted 1:1000. The preparation provides an objective assessment of red cell washer efficacy and the confidential, in-house assessment of operator variability in detecting weak but definite macroscopic agglutination by blind, replicate tests. Red cell washer efficacy and poor operator reading procedures causing disruption of weak agglutination are two major causes of false-negative antiglobulin tests; neither are adequately detected by the common quality-control procedure of adding strongly IgG-sensitized red cells ('Coombs control cells') to apparently negative antiglobulin tests. However, weakly IgG-sensitized red cells do offer a valuable control function that can detect some degree of cell washer inefficiency and reading errors although such cells are not a substitute for the more sensitive replicate testing. Test protocols are provided to assess the efficacy of cell washing machines and operator skills in the detection of weak but definite macroscopic agglutination.
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Affiliation(s)
- P K Phillips
- National Institute for Biological Standards and Control, Potters Bar, U.K
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23
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Deffune E, Le Pennec PY, Lascaux JM, Rouger P. [Method for studying anti-complement reagents: use of freeze-thawed sensitized erythrocytes]. Rev Fr Transfus Hemobiol 1992; 35:299-309. [PMID: 1476585 DOI: 10.1016/s1140-4639(05)80105-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The use of red blood cells coated with complement fractions using low ionic strength saline conditions is part of the evaluation of anti-complement antibodies, specially monoclonal antibodies used for antiglobulin reagents. This work shows that such cells stored in liquid nitrogen allow satisfactory long-term studies except for the anti-C3g antibodies.
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Affiliation(s)
- E Deffune
- Conselho Nacional de Pesquisa Cientifica, Brasilia
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24
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Issitt PD, Gutgsell NS. [Hemolytic anemia, caused by "warm" antibodies, in negative direct antiglobulin test]. Gematol Transfuziol 1992; 37:29-32. [PMID: 1426906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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25
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Abstract
A retrospective study of pretransfusion testing records compared the utility of the antiglobulin test (AGT) phase of the crossmatch and the autologous control (autocontrol) for detecting clinically significant alloimmunization to red cells (RBCs). Of 110,780 consecutive crossmatches, 141 were positive after a negative antibody screening test; only 4 of these were due to alloantibodies of potential clinical significance, for a predictive value of a positive AGT crossmatch, after a negative antibody screen, of 2.8 percent (4/141). The frequency of potentially shortened RBC survival was 1 in 27,685 units crossmatched. During a similar period, 56,090 autocontrols were performed with the antibody screen. The autocontrol was positive on 902 samples in which the antibody screen was negative. Antibody identification performed in 684 cases generally yielded only cold or warm autoagglutinins. In 96 cases, some form of alloantibody was detected, but only 25 had potential clinical significance by our criteria. Eight of these alloantibodies had concurrently caused in vivo sensitization of RBCs and were classified as delayed hemolytic transfusion reactions. The predictive value of the autocontrol, calculated as the number of significant alloantibodies detected in autocontrol-positive, antibody-screen-negative samples, was 3.6 percent (25/684). Inspection of these cases revealed 11 in which shortened RBC survival might have resulted if the serologic abnormality had not been detected. Thus, the autocontrol had a slightly greater yield of clinically significant findings than the AGT crossmatch.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- J T Perkins
- University of Illinois Hospital Blood Bank, Chicago
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26
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Jones DR, Gruffydd-Jones TJ, Stokes CR, Bourne FJ. Investigation into factors influencing performance of the canine antiglobulin test. Res Vet Sci 1990; 48:53-8. [PMID: 2300716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Antiglobulin (Coombs') reagents were assessed for their ability to detect immunoglobulin and complement attached to red cells. Polyspecific and monospecific reagents were prepared using a number of immunisation protocols. Performance of these antisera against control red cells was compared, in a direct Coombs' test, with samples from cases of canine autoimmune haemolytic anaemia (AIHA). A combined reagent containing two monospecific antisera (anti-IgG + anti-C3) gave optimum results. Positive control red cells were required to standardise canine Coombs' reagents for the laboratory diagnosis of AIHA. The optimum incubation temperature for the canine Coombs' test was shown to be 37 degrees C.
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Affiliation(s)
- D R Jones
- University of Bristol, Department of Veterinary Medicine, Langford
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27
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Holburn AM, Prior DM, Whitton CM. The UK National External Quality Assessment Scheme in Blood Group Serology. ABO and D grouping, antibody screening, direct antiglobulin test and antibody identification 1984-1985. Clin Lab Haematol 1988; 10:73-85. [PMID: 3130215 DOI: 10.1111/j.1365-2257.1988.tb01155.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
In seven exercises of blood grouping the overall rates of major error were 0.19% and 0.25% in ABO and D grouping respectively. In ABO grouping this represents an increase in error rate over that observed in 1982-1983 but the increase was due to an unusually high error rate with one particular group A2B cell. An improvement in performance was observed in simple D grouping and was largely due to a lower incidence of false positive grouping of D-negative cells in the antiglobulin test. An improvement in performance observed in D grouping IgG-coated D-negative cells appeared to be due to a better understanding of the problem rather than to any change in serological practice. Error rates in antibody screening were somewhat lower than in 1982-1983 but this may or may not represent an improvement in performance as the test materials were not the same in the two periods. The direct antiglobulin test with IgG-coated cells was reliably performed with polyspecific and with anti-IgG reagents but an excess of false positive results was obtained with anti-C3d. Error rates in antibody identification varied from 0.6% for anti-D to 74% for anti-c + E.
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Affiliation(s)
- A M Holburn
- Blood Group Reference Laboratory, Oxford, UK
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28
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Zachary AA. The antiglobulin crossmatch in the cyclosporine era. Transplantation 1987; 44:333-4. [PMID: 3629687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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29
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Abstract
The investigation of a failure of proficiency showed that certain saline solutions are inappropriate for use in blood group serology tests. In particular, it was found that solutions of unexpectedly low pH and/or those autoclaved and stored in plastic containers could severely compromise the sensitivity of the antiglobulin test when used as wash solutions. The observed loss of sensitivity ranged from a reduction in titration score to a complete failure in the detection of clinically significant blood group antibodies. It is suggested that careful consideration should be given to the source, pH, and storage container of saline solutions intended for use in serological tests and that improved standardization and sensitivity could be achieved by using phosphate-buffered saline pH 7.0 to 7.2 for all such purposes. It is recommended that unbuffered saline solutions of pH less than 6.0 should not be used for serological testing.
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30
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Ferrer Z, Wright J, Moore BP, Freedman J. Comparison of a modified manual hexadimethrine bromide (Polybrene) and a low-ionic-strength solution antibody detection technique. Transfusion 1985; 25:145-8. [PMID: 3984009 DOI: 10.1046/j.1537-2995.1985.25285169208.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Manual hexadimethrine bromide (Polybrene) tests (Polybrene in low-ionic medium) were used in parallel with manual low-ionic-strength solution (LISS) procedures for the routine testing of patient samples referred to a general hospital blood bank. Of 5646 consecutive sera tested, 5167 (91.5%) did not react with either technique; 320 sera (5.7%) reacted in both methods. The Polybrene technique detected 63 antibodies which did not react in the LISS methods. One hundred sera did not react in the Polybrene test, but did react in the LISS methods. Sera showing discrepant results between the two methods were further tested in a reference laboratory. Polybrene tests appeared to be better in avoiding reactions due to clinically nonsignificant antibodies. The LISS methods, however, appeared to be more sensitive in detecting antibodies of potential clinical significance.
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31
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Orsini F, O'Donnell A, Fitzpatrick J, Birl T, Mink I, Dozier A. Enhancement of the indirect anti-platelet antibody test and its application to platelet immunology. Transfusion 1985; 25:63-7. [PMID: 3969703 DOI: 10.1046/j.1537-2995.1985.25185116507.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Comparisons in the same patients of platelet-bound anti-platelet antibody (APA) levels (direct test) with serum APA levels (indirect test) frequently do not give the same results. Indirect test results frequently are negative or marginally elevated even though platelet-bound antibody is greatly increased on direct testing. The most likely cause for these differences between the two tests is insufficient binding of serum antibody to test platelets in vitro. In an effort to enhance in vitro antibody binding, we examined four test modifications affecting platelet attachment. Rabbit anti-human platelet antisera (absorbed with their specific human donor leukocytes to remove HLA- and granulocyte-specific antibodies) were combined under various conditions with human platelets and tested in a modified antiglobulin consumption test utilizing rabbit IgG. The test conditions varied: incubation time of the serum APA-platelet mixture at 37 degrees C; age of the test platelet pool; ionic strength of the mixture (varied through incorporation of a low-ionic-strength solution (LISS); and vortex agitation for 30 seconds prior to the addition of sera. Optimal attachment in standard phosphate-buffered saline took place in 60 minutes using test platelets stored for either 3 or 30 days, and yielded mean values for rabbit immune sera of 9.9 fg of IgG per platelet. Preincubation controls yielded a mean of 0.7 to 1.5 fg per platelet. Incorporation of LISS or vortexing of test platelets did not affect the results of control, but both modifications substantially increased test values of immune sera to 15.8 and 17.3 fg of IgG per platelet, respectively. Combining LISS with vortexing did not further increase values.
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Diluents as controls. Transfusion 1981; 21:131-3. [PMID: 7466903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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33
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Garratty G, Petz LD. The significance of red cell bound complement components in development of standards and quality assurance for the anti-complement components of antiglobulin sera. Transfusion 1976; 16:297-306. [PMID: 951725 DOI: 10.1046/j.1537-2995.1976.16476247049.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Human red blood cells, sensitized with complement in vivo and by a variety of methods in vitro, (e.g. blood group antibody, low ionic strength, alternate pathway), were tested with a battery of anti-complement sera (anti-C3, -C3c, -C3d, -C4, -C4c). Red blood cells could be prepared by relatively simple methods to yield cells sensitized with C3 and C4, C3 but not C4, C4 but no C3, C3d with no C3c and C4d with no C4c. These cells are suitable for standarization and quality assurance of antiglobulin sera (AGS). Anti-C3d is necessary for optimal detection of sensitization of red blood cells by complement in vivo by the direct anti-globulin test (DAT). Anti-C3d may also be optimal for the indirect antiglobulin test (IAT) especially if incubation periods greater than one hour are employed. Potent anti-C4 and anti-C3 antisera made in the authors' laboratory resulted in numerous weakly positive antiglobulin tests when testing red blood cells from refrigerated clots (especially anti-C4) but red blood cells from refrigerated anticoagulated segments gave negative results. When red blood cells were incubated in normal serum at room temperature (as in the room temperature phase of a compatibility test), some positive results were again obtained with the potent anti-C4 and anti-C3 antisera. However, one commercial antiglobulin serum containing anti-complement antibodies that were at least as potent as any other commercial antiglobulin serum gave uniformly negative results under the above conditions. Anti-C4 antibodies may be omitted from anti-globulin sera without decreasing the efficacy of such antisera to be used in compatibility testing. Thus, positive results in the compatibility test due to detection of clinically insignificant cold antibodies in the IAT by the anti-complement antibodies in AGS, may be avoided if anti-C4 is omitted or is in low concentration and if the concentration of anti-C3d is carefully standardized. A higher concentration of anti-C3d could be used for compatibility tests if red blood cells from anticoagulated segments were used instead of those from clots and if a separate tube were used for the IAT at 37 C rather than using one tube for both room temperature and 37 C incubations.
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34
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Hinchliffe PM, Robertson L, Farrell ID. A screening method for the detection of Brucella antibodies in human serum. J Clin Pathol 1975; 28:50-3. [PMID: 804496 PMCID: PMC475593 DOI: 10.1136/jcp.28.1.50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The antiglobulin consumption test of Steffen (1954) has been adapted for the detection of Brucella antibodies in human serum. This screening method takes approximately two hours to complete and sera which give a negative result need no further investigations, whilst positive sera should be fully tested by the conventional Brucella serology technique.
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35
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Burkart P, Rosenfield RE, Hsu TC, Wong KY, Nusbacher J, Shaikh SH, Kochwa S. Instrumented PVP-augmented antiglobulin tests. I. Detection of allogeneic antibodies coating otherwise normal erythrocytes. Vox Sang 1974; 26:289-304. [PMID: 4210485 DOI: 10.1111/j.1423-0410.1974.tb02701.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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36
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37
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Moore BP, Maldre L. Techniques for the selection of antiglobulin (Coombs') reagents. Can J Med Technol 1973; 35:6-7. [PMID: 4541319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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38
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Mueller-Eckhardt C, Kretschmer V. Autoimmune hemolytic anemias. I. Investigations on immunoglobulin type and complement fixation of cell-fixed and eluable autoantibodies. Blut 1972; 25:63-76. [PMID: 5050157 DOI: 10.1007/bf01633870] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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39
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Spielmann W, Allen FH, Engelfriet CP, Freiesleben E, Greenwalt TJ, Huestis DW, Myhre BA, Salmon C. What constitutes adequate routine Rh typing on donors and recipients? Vox Sang 1971; 21:183-92. [PMID: 5000960 DOI: 10.1111/j.1423-0410.1971.tb00575.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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40
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41
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Wisniowski J, Krolak M, Drozdzynska M. Standardization trial of the antiglobulin (Coombs) test applied in the serological diagnosis of brucellosis in cattle. Bull Off Int Epizoot 1971; 75:217-29. [PMID: 5166335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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