非溶血性輸血副作用惹起患者より検出された同種抗ＩｇＡ抗体について

Abstract

We used an enzyme-liked immunosorbent assay (ELISA) using polyclonal IgA purified from pooled plasma as an antigen for the screening of anti-IgA antibodies in sera from patients with nonhemolytic transfusion reactions (NHTRs). Among 154 patients referred to our laboratory from April 1994 to January 1995, two were positive for anti-IgA IgG antibodies. Specificites of the anti-IgA antibodies were examined by immunoblotting. Anti-IgA2m(1) and anti-IgA1 were detected in one case each. Sera from both patients contained normal levels of total IgA. In one case, a 43-year-old woman with chronic myelogenous leukemia showed urticaria followed by wheezing dyspnea and fever one hour after the start of platelet concentrate (PC) transfusion. In the other case, a 45-year-old woman with aplastic anemia complained of itching, urticaria, facial edema and nausea immediately after the start of PC transfusion. No antibodies against HLA, platelet-specific antigens or irregular antibodies against red blood cell antigens were detected in either patients' sera collected before transfusion or in the transfused blood in these cases. These findings suggested that these NHTRs might have been caused by subclass and allotype-specific anti-IgA antibodies. These results show that ELISA and Western blotting are useful in the detection of anti-IgA antibodies responsible for NHTRs.