The Hematologic System and its Disorders
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss in Understanding Medical Terms, 2020
Different types of blood can be classified on the basis of cell membrane proteins that normally cause antibody reactions. Thus, blood may be grouped as type O, A, B, or AB, These four groups are based on the presence or absence in blood cells of the type A and type B proteins that may cause transfusion reactions. Called agglutinogens because they lead to agglutination (clumping) and hemolysis (rupture) of blood cells exposed to specific antibodies, these proteins react with agglutinins in the plasma to cause the cells to clump. Those people without a specific agglutinogen usually do have the complementary agglutinin in their plasma.
Growth Factor Receptors
Enrique Pimentel in Handbook of Growth Factors, 2017
Lateral mobility and aggregation (clustering) of growth factor-receptor complexes on the cell surface are important for the physiological activities of many of these agents. Plant lectins such as concanavalin A or wheat germ agglutinin are multivalent molecules that bind to specific carbohydrates on the cell surface and can crosslink various cell surface receptors. Lectins may display striking effects at the level of the plasma membrane. They may decrease EGF- and insulin-stimulated DNA synthesis.46 A close relationship between receptor aggregation/immobilization and response has been observed in a number of cellular systems. For many cell surface receptors, crosslinking by antireceptor antibodies is sufficient for receptor activation. This is not a general rule, however. The NGF receptor is preclustered and immobile on responsive cells, which suggests that immobilization of the receptor prior to ligand binding is required for signal transduction.47 In general, there are two classes of cell surface receptors: those that are preclustered and immobile and those that only become clustered and immobile upon ligand binding.
Candidiasis
Rebecca A. Cox in Immunology of the Fungal Diseases, 2020
A number of different serologic tests, including whole cell agglutination,191 double-immunodiffusion,192 counter immunoelectrophoresis (CIE),193 co-counterimmunoelectropho- resis,194 latex agglutination,195 crossed immunoelectrophoresis (XIE),196 ELISA,197,198 passive hemagglutination,198 and radioimmunoassay199 have been proposed at one time or another as diagnostic or prognostic aids in candidiasis. It became clear early,191 however, that agglutinins, i.e., antibodies to the surface antigens of Candida, were present in a relatively large percentage of normal individuals, and, while the concentration of such antibodies was usually greater in patients with candidiasis, the differential was not great enough to make the agglutinin response a reliable indicator of disease status.
Transitioning Select Chemotherapeutics to the Outpatient Setting Improves Care and Reduces Costs
Published in Oncology Issues, 2021
Ali Mcbride, Daniel Persky
Since 2015 when we transitioned certain rituximab administrations to the outpatient setting, we decreased our inpatient bed stays, reduced our inpatient chemotherapy costs, and increased the use of our own specialty pharmacy for patients receiving intravenous rituximab combination regimens, as well as an increased use of this model post-implementation for standard order sets. However, not every patient receiving rituximab can be treated in the outpatient setting. Accordingly, we have developed patient restrictions for rituximab in the outpatient setting, including:Immune thrombocytopenic purpura—dose-reduced rituximab, 100 mg9.Cold agglutinin disease.Post-transplant lymphoproliferative disease.Autoimmune hemolytic anemia.Prolonged chemotherapy inpatient stays requiring continued treatment.Infusion reaction or need for rituximab desensitization.
Multifactorial jaundice and pigmented choledocholithiasis secondary to warm autoimmune hemolytic anemia and alcoholic cirrhosis
Published in Baylor University Medical Center Proceedings, 2022
Colten Watson, Mazen Hassan, Grant Breeland
Upon admission, the patient’s skin was highly jaundiced with a measured bilirubin of 43.8 mg/dL and a blood pressure of 104/50 mm Hg. Acute diffuse abdominal pain was present on palpation. Some shortness of breath was noted with rhonchi and abdominal distention. A rectal exam was guaiac positive and showed occult blood. His hemoglobin was 6.3 g/dL, resulting in the immediate transfusion of 4 units of packed red blood cells on his first day of admission. His total bilirubin of 43.8 mg/dL was fractionated, and direct bilirubin measured 32.7 mg/dL. The blood bank laboratory tests also had several findings; an antibody screen was positive and was confirmed with a direct Coombs test. The lab then discovered a warm agglutinin IgG antibody through a direct antiglobulin test. Other notable laboratory data included a lipase level of 390 U/L, elevated lactate dehydrogenase, decreased haptoglobin, and 1+ schistocytes (Supplemental Table).
Autoimmune hemolytic anemia: causes and consequences
Published in Expert Review of Clinical Immunology, 2022
B Fattizzo, W Barcellini
In all patients, the clinical evaluation is completed by the investigation of underlying alloantibodies in patient’s serum (indirect agglutinin test, IAT), reported in about one-third of AIHA patients [22]. The latter may cause severe hemolytic reactions in the case of transfusion. In complex cases, allo- and autoantibody may be distinguished by immune-absorbance techniques and extended RBC genotyping [3]. Additionally, autoantibodies may be eluted from the washed patient’ RBCs to determine the class, specificity, titer, and thermal range. As regards specificity, in wAIHA autoantibodies are mainly directed against RBC membrane proteins including Band 3, glycophorin A, and Rh system, while in CAD the polysaccharide regions of glycoproteins, such as I/i or Pr antigen, are the most common target.