Early primary immune response against erythrocytes: a case report

BACKGROUND

Primary immune response against red blood cell (RBC) antigens often takes weeks or months to be detected. In previous reports, for children receiving multiple units of blood components, ranging from five to 81 units, the elapsed time between the first RBC transfusion and antibody detection ranged from 18 to 78 days. Cytomegalovirus (CMV) is sometimes associated with immunohaematologic findings and may modulate immune response.

CASE REPORT

A 24-week-old male infant with interstitial pneumonia and hepatitis because of CMV developed an RBC auto antibody and two RBC alloantibodies: anti-Jka, detected in tube 11 days after a single RBC transfusion, and anti-K, detected only in papain gel test 18 days later.

CONCLUSION

As anti-Jka is not a naturally occurring antibody, this is the most rapid primary immune response against an RBC antigen after a single RBC transfusion ever described, in the youngest child ever described.

[Use of blood and blood components and derivatives in newborn infants]

OBJECTIVE: To describe the current rationale for the transfusion of blood, blood components, and plasma derivatives in term and preterm infants. SOURCES: Selection of relevant medical articles published within the last ten years. SUMMARY OF THE FINDINGS: Peculiar characteristics and special care concerning exchange transfusion, transfusion of red blood cells, platelets, granulocytes, and fresh frozen plasma were described. The recommendations for the use of hematopoietic growth factors, and plasma derivatives such as fibronectin, immunoglobulins, and albumin were also evaluated. CONCLUSIONS: The authors comment on the recommendations and contraindication of blood transfusions, and warn against the limitations and hazards involved.

Antiulcer effectiveness of Maytenus aquifolium spray dried extract

The antiulcer activity of Maytenus aquifolium spray dried extract was studied in rats. Ulcers were induced by means of three experimental models: acidified-ethanol, indomethacin and acute stress. The extract was found to have significant antiulcer activity against all the models studied. These results show that preparation of the extract by means of the spray dried technique does not alter the biological activity of Maytenus aquifolium.

Effect of Maytenus aquifolium extract on the pharmacokinetic and antiinflammatory effectiveness of piroxicam in rats

This study explored the interference by Maytenus aquifolium leaves hydroalcoholic (MALHE) extract, administered orally, on the pharmacokinetic and antiinflammatory activity of piroxicam in rats. The results showed no significant difference in piroxicam bioavailability with simultaneous application of MALHE. MALHE also had no effect on the inhibitory effect of piroxicam on inflammatory processes induced by carrageenan and complete Freund adjuvant.

[Blood component transfusion in full-term and premature new born infants]

BACKGROUND

Blood transfusion requirements for preterm infants are greater than for newborn ones. We compare blood transfusion requirements for newborn and premature infants and their pathology: clinical or surgical; hemorrhagic accidents and survival.

METHODS

48 newborns classified in 2 groups: 26 newborn and 22 preterm infants received 251 units of blood components: 177 units of red cell concentrates, 36 of platelet concentrates, 30 of fresh frozen plasma and 8 of total blood in a 186 days period. We analyzed total requirements of components in each group and daily, under a live-infant/day rate until 120 days.

RESULTS

The all-components median requirements were 7.31 units for premature and 3.46 for newborn infants. Daily requirements analyzes reveal that requirements were greater before 60th day of life (d.l.) on clinical patients and after 86th d.l. may be caused by surgical acts. Hemorrhagic accidents happen on premature with less than 60,000 platelets/mm3. The survival wave by number of transfusions, until 186 d.l., show an inversely proportional trend between the number of transfusions done and the hope of life.

CONCLUSIONS

Blood requirements for preterm infants are greater than for term ones. Those requirements are related to their pathology. Prophylatic platelet transfusions may reduce hemorrhagic accidents then red blood cell transfusions in preterm infants group. The number of transfusions over 10 is a surrogate marker of bad prognosis for both groups up to 120 d.l.