Analysis of blood group serological detecting characteristics in patients with autoimmune disease before blood transfusion

Abstract

Objective To investigate the blood group serological detecting characteristics in patients with autoimmune disease before blood transfusion. Methods From January 2008 to December 2015, a total of 6 890 patients with autoimmune disease in Xijing Hospital of the Fourth Military Medical University were included in the study.They were plan to take blood transfusion. Inclusion criteria of the study: patients′ diagnoses were conformed as autoimmune disease and clinical data were complete. Blood type identification, antibody screening, antibody identification and cross matching of blood correlation detection were taken by the classical test tube method, microcolumn gel method, anti human globulin test, absorption elution tests and so on. Exclusion criteria: other anemia disease and clinical data were not complete. The study protocol was approved by the Ethical Review Board of Investigation in Human of Xijing Hospital of the Fourth Military Medical University. Results ①There were 370 cases with unconformity of positive and reverse ABO blood typing(5.4%, 370/6 890). The reason of unconformity of positive and reverse ABO blood typing were immunoglobulin(Ig)M irregular antibodies(32.4%, 120/370), cold autoantibodies(26.8%, 99/370), cold lectin(16.2%, 60/370), rouleaux agglutination(11.1%, 41/370), direct antiglobulin test positive(9.5%, 35/370), antigen and antibody weakened(4.0%, 15/370) .②There were 570 patients with irregular antibody(8.3%, 570/6 890). The main type of the irregular antibody were combined antibodies(44.0%, 251/570), homologous antibody(35.8%, 204/570), cold and warm autoantibodies(13.9%, 79/570), autoantibodies with mimicking specificity(4.4%, 25/570), drug antibody(1.9%, 11/570). ③There were 610 cases with difficulty in cross matching(8.8%, 610/6 890). The main disease of them were autoimmune hemolytic anemia(34.9%, 213/610), connective tissue disease(19.0%, 116/610), systemic lupus erythematosus(14.8%, 90/610), rheumatoid arthritis(9.0%, 55/610), lupus nephritis(5.7%, 35/610) and so on. Conclusions Autoimmune disease can easily cause difficulties in blood type identification and cross matching.Through the blood group serological detection of patients with immune disease before blood transfusion, it can find out the reasons of unconformity of positive and reverse ABO blood typing, and choose the suitable blood components, in order to ensure the safe and effective in clinical blood transfusion. Key words: ABO blood-group system; Blood transfusion; Blood grouping and crossmatching; Immunological disease