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Alloimmunity

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https://www.readbyqxmd.com/read/28436749/differential-diagnosis-of-neonatal-alloimmune-thrombocytopenia-type-2b-von-willebrand-disease
#1
Mathilde Penel-Page, Sandrine Meunier, Mathilde Fretigny, Sandra Le Quellec, Pierre Boisseau, Christine Vinciguerra, Catherine Ternisien, Lucia Rugeri
At birth, severe thrombocytopenia without context of infection should mainly suggest neonatal alloimmune thrombocytopenia (NAIT), especially in case of a platelet count below 20 GL(-1). We report two cases of severe neonatal thrombocytopenia, first suspected as being NAIT. Both had a platelet count below 20 GL(-1) with platelet clumps. The absence of alloantibodies and failure of platelet transfusion and intravenous immunoglobulins to improve the platelet count led to question the diagnosis and to evoke inherited bleeding disorders...
April 24, 2017: Platelets
https://www.readbyqxmd.com/read/28427861/divergent-function-of-programmed-death-ligand-1-in-donor-tissue-versus-recipient-immune-system-in-a-murine-model-of-bronchiolitis-obliterans
#2
Katharina Schütte-Nütgen, Olaf Boenisch, Hakima Harrach, Alicia Casey, Indira Guleria, Nader Najafian, Mohamed H Sayegh, Craig J Gerard, Meera Subramaniam
Costimulatory molecules, such as the programmed death ligand (PD-L1), might exert differential effects on T-cell function, depending on the clinical setting and/or immunological environment. Given the impact of T cells on bronchiolitis obliterans (BO) in lung transplantation, we used an established tracheal transplant model inducing BO-like lesions to investigate the impact of PD-L1 on alloimmune responses and histopathological outcome in BO. In contrast to other transplant models in which PD-L1 generally shows protective functions, we demonstrated that PD-L1 has divergent effects depending on its location in donor versus recipient tissue...
April 17, 2017: American Journal of Pathology
https://www.readbyqxmd.com/read/28427432/anti-human-platelet-antigen-hpa-1a-antibodies-may-affect-trophoblast-functions-crucial-for-placental-development-a-laboratory-study-using-an-in-vitro-model
#3
Mariana Eksteen, Gøril Heide, Heidi Tiller, Yan Zhou, Nora Hersoug Nedberg, Inigo Martinez-Zubiaurre, Anne Husebekk, Bjørn R Skogen, Tor B Stuge, Mette Kjær
BACKGROUND: Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is a bleeding disorder caused by maternal antibodies against paternal human platelet antigens (HPAs) on fetal platelets. Antibodies against HPA-1a are accountable for the majority of FNAIT cases. We have previously shown that high levels of maternal anti-HPA-1a antibodies are associated with clinically significant reduced birth weight in newborn boys. Chronic inflammatory placental lesions are associated with increased risk of reduced birth weight and have previously been reported in connection with FNAIT pregnancies...
April 21, 2017: Reproductive Biology and Endocrinology: RB&E
https://www.readbyqxmd.com/read/28425750/modeling-alloantibody-formation-to-high-incidence-red-blood-cell-antigens-in-immune-responders-using-genotypic-data
#4
Patricia A R Brunker, Keerthana Ravindran, R S Shirey
Alloimmunization to red blood cell antigens is unpredictable and poorly understood. Patients who are negative for high-incidence antigens (HIAs) are at risk for developing the corresponding antibodies. Molecular methods can easily predict the lack of an antigen and thus, the risk of an individual to become immunized. We examined the prevalence and risk factors for HIA alloimmunization in patients at risk based on genotyping results. Genotyping using a molecular method (HEA BeadChip™, Immucor, Warren, NJ) was performed on all patient specimens referred for molecular testing over 45 months; serologic and clinical data were analyzed...
January 2017: Immunohematology
https://www.readbyqxmd.com/read/28421078/genetic-association-of-hematopoietic-stem-cell-transplantation-outcome-beyond-histocompatibility-genes
#5
REVIEW
Rihab Gam, Pranali Shah, Rachel E Crossland, Jean Norden, Anne M Dickinson, Ralf Dressel
The outcome of hematopoietic stem cell transplantation (HSCT) is controlled by genetic factors among which the leukocyte antigen human leukocyte antigen (HLA) matching is most important. In addition, minor histocompatibility antigens and non-HLA gene polymorphisms in genes controlling immune responses are known to contribute to the risks associated with HSCT. Besides single-nucleotide polymorphisms (SNPs) in protein coding genes, SNPs in regulatory elements such as microRNAs (miRNAs) contribute to these genetic risks...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28419453/obstetrics-and-gynecology-physician-knowledge-of-rh-immune-globulin-prophylaxis
#6
Amy Yu, Erin Morris, Richard Adams, Mark K Fung
BACKGROUND: Previous studies have shown that more than 20% of laboratories would have recommended inaccurate doses of Rh immune globulin (RhIG) in hypothetical cases. Efforts have been made in educating laboratories in correct dosing calculations; however, obstetricians are most often responsible for ordering RhIG. The objective of this study was to assess knowledge of RhIG indications and dosing among obstetrics and gynecology (OB/GYN) physicians in the United States. STUDY DESIGN AND METHODS: An anonymous 17- question online survey was distributed to all OB/GYN resident and attending physicians affiliated with US residency training programs...
April 16, 2017: Transfusion
https://www.readbyqxmd.com/read/28419427/how-i-manage-children-with-neutropenia
#7
REVIEW
David C Dale
Neutropenia, usually defined as a blood neutrophil count <1·5 × 10(9) /l, is a common medical problem for children and adults. There are many causes for neutropenia, and at each stage in life the clinical pattern of causes and consequences differs significantly. I recommend utilizing the age of the child and clinical observations for the preliminary diagnosis and primary management. In premature infants, neutropenia is quite common and contributes to the risk of sepsis with necrotizing enterocolitis...
April 17, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28413208/anti-m-induced-severe-haemolytic-disease-of-foetus-and-newborn-in-a-malay-woman-with-recurrent-pregnancy-loss
#8
H Mohd Nazri, M N Noor Haslina, M Y Shafini, A R Noor Shaidatul Akmal, M Rapiaah, A Wan Zaidah
Haemolytic disease of the foetus and newborn (HDFN) is caused by maternal red blood cells (RBC) alloimmunisation resulted from incompatibility of maternal and foetal RBCs. However, only a few HDFN attributed to anti-M were reported, varying from asymptomatic to severe anaemia with hydrops foetalis and even intrauterine death. A case of severe HDFN due to anti-M alloantibody from an alloimmunized grandmultiparous Malay woman with recurrent pregnancy loss is reported here. The newborn was delivered with severe and prolonged anaemia which required frequent RBC transfusions, intensive phototherapy and intravenous immunoglobulin administration...
April 2017: Malaysian Journal of Pathology
https://www.readbyqxmd.com/read/28411255/absence-of-the-spleen-and-the-occurrence-of-primary-red-cell-alloimmunization-in-humans
#9
Dorothea Evers, Johanna G van der Bom, Janneke Tijmensen, Masja de Haas, Rutger A Middelburg, Karen M K de Vooght, Daan van de Kerkhof, Otto Visser, Nathalie C V Péquériaux, Francisca Hudig, Jaap Jan Zwaginga
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April 14, 2017: Haematologica
https://www.readbyqxmd.com/read/28406722/development-of-quantitative-monoclonal-antibody-specific-immobilization-of-platelet-antigens-assay-for-antibodies-against-human-platelet-antigen-1a-3a-and-5b
#10
R S Li, B Ling, P Lu
Human platelet antigens (HPAs) are platelet-specific alloantigens that cause alloimmunization. Alloantibodies induced via pregnancy and transfusion may result in various clinical syndromes. The monoclonal antibody-specific immobilization of platelet antigens (MAIPA) assay is the gold standard for the detection and identification of HPA antibodies. The present study aimed to develop standardized quantitative MAIPA assays for antibodies against HPA-1a, 3a, and 5b. MAIPA protocol was applied on serial dilutions of standard or reference reagents containing antibodies against HPA-1a, 3a, and 5b...
April 13, 2017: Platelets
https://www.readbyqxmd.com/read/28402005/prevalence-and-risk-factors-for-red-blood-cell-alloimmunization-in-175-children-with-sickle-cell-disease-in-a-french-university-hospital-reference-centre
#11
Slimane Allali, Thierry Peyrard, Denise Amiranoff, Jérémie F Cohen, Martin Chalumeau, Valentine Brousse, Mariane de Montalembert
Patients with sickle cell disease (SCD) show a high prevalence of red blood cell (RBC) alloimmunization, but few studies have focused on children. We aimed to study the prevalence and risk factors of RBC alloimmunization in SCD children. We retrospectively analysed the medical and transfusion files for 245 SCD children hospitalized in our centre in 2014 and included 175 patients who had received at least one RBC unit in their lifetime. The main clinical and immuno-haematological characteristics of alloimmunized and non-alloimmunized patients were compared...
April 12, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28401538/women-s-attitude-towards-routine-hpa-screening-in-pregnancy
#12
Dian Winkelhorst, Rosanne M Loeff, Elske van den Akker-van Marle, Masja de Haas, Dick Oepkes
Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is a potentially life-threatening disease with excellent preventative treatment available for subsequent pregnancies. In order to prevent index cases, the effectiveness of a population-based screening program has been suggested repeatedly. Therefore, we aimed to evaluate women's attitude towards possible future human platelet antigen (HPA)-screening in pregnancy MATERIAL AND METHODS: We performed a cross-sectional questionnaire study amongst healthy pregnant women receiving prenatal care in one of seven participating midwifery practices...
April 12, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28397655/-liver-failure-in-neonatal-children-is-a-diagnostic-challenge
#13
Heidi Smedegaard, Vibeke Brix Christensen, Morten Hanefeld Dziegiel, Marianne Hørby Jørgensen
This case report presents a newborn boy with hypoglycaemia, anaemia, jaundice and severe coagulopathy during the first day of his life, imitating sepsis and disseminated intravascular coagulation. One week after the birth he was diagnosed with acute liver failure due to gestational alloimmune liver disease (GALD). Despite the fact that GALD is rare, it must be suspected in all unexplained stillborn children and infants with severe liver disease. If diagnosed, it is possible to prevent death and severe liver failure in future newborns by treating the affected women with immunoglobulin during pregnancy...
March 27, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28377559/recent-advances-in-understanding-the-clinical-relevance-of-antiplatelet-alloantibodies
#14
Katarzyna Guz, Małgorzata Uhrynowska, Izabella Kopeć, Marzena Dębska, Anne Husebekk, Ewa Brojer
Alloimmunization to human platelet antigens (HPAs) may occur either during pregnancy, when a HPA‑negative mother gives birth to a newborn who inherits HPAs from the father, or following blood transfusion or stem cell transplantation. Antiplatelet alloantibodies do not cause thrombocytopenia in a patient, but their detection must always be recorded in medical records because they may induce fetal and neonatal alloimmune thrombocytopenia in present and all subsequent pregnancies, platelet refractoriness, posttransfusion purpura, or prolonged thrombocytopenia with engraftment failure after stem cell transplantation...
March 31, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28374955/rhd-alleles-among-pregnant-women-with-serologic-discrepant-weak-d-phenotypes-from-a-multiethnic-population-and-risk-of-alloimmunization
#15
Carolina Bonet Bub, Maria Giselda Aravechia, Thiago Henrique Costa, José Mauro Kutner, Lilian Castilho
BACKGROUND: A considerable number of RHD alleles responsible for weak and partial D phenotypes have been identified. Serologic determination of these phenotypes is often doubtful and makes genetic analysis of RHD gene highly desirable in transfusion recipients and pregnant women. We analyzed the RHD gene in a cohort of pregnant women with doubtful D phenotypes. METHODS: RHD genotyping was performed on 104 cases with D typing discrepancies or with history of serologic weak D phenotype...
April 4, 2017: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/28371365/a-memory-b-cell-crossmatch-assay-for-quantification-of-donor-specific-memory-b-cells-in-the-peripheral-blood-of-hla-immunized-individuals
#16
G E Karahan, Y J H de Vaal, J Krop, C Wehmeier, D L Roelen, F H J Claas, S Heidt
Humoral responses against mismatched donor HLA are routinely measured as serum HLA antibodies, which are mainly produced by bone-marrow residing plasma cells. Individuals with a history of alloimmunization but lacking serum antibodies may harbor circulating dormant memory B cells, which may rapidly become plasma cells upon antigen re-encounter. Currently available methods to detect HLA-specific memory B cells are scarce and insufficient in quantifying the complete donor-specific memory B cell response due to their dependence on synthetic HLA molecules...
March 30, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28370162/simultaneous-human-platelet-antigen-genotyping-and-detection-of-novel-single-nucleotide-polymorphisms-by-targeted-next-generation-sequencing
#17
Sue Davey, Cristina Navarrete, Colin Brown
BACKGROUND: Twenty-nine human platelet antigen systems have been described to date, but the majority of current genotyping methods are restricted to the identification of those most commonly associated with alloantibody production in a clinical context. This can result in a protracted investigation if causative human platelet antigens are rare or novel. A targeted next-generation sequencing approach was designed to detect all known human platelet antigens with the additional capability of identifying novel mutations in the encoding genes...
March 28, 2017: Transfusion
https://www.readbyqxmd.com/read/28370062/simultaneous-genotyping-of-human-platelet-alloantigen-1-to-28bw-systems-by-multiplex-polymerase-chain-reaction-sequence-based-typing
#18
X Hong, S Chen, Y Ying, Y Liu, X Xu, J He, F Zhu
BACKGROUND AND OBJECTIVES: Human platelet alloantigen (HPA) genotyping is important for the diagnosis and prevention the alloimmune platelet disorders. In this study, a simultaneous genotyping method for HPA-1 to -28bw systems was established using multiplex PCR-SBT and the frequencies of genotypes and alleles of HPA-1 to -28bw systems in the Zhejiang Han population were analysed. MATERIALS AND METHODS: The specific primers were designed according to the nucleotide sequences of HPA-1 to 28bw systems which are located in ITGB3, GP1BA, ITGA2B, ITGA2, GP1BB and CD109, respectively...
March 31, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/28369969/a-rare-potentially-life-threatening-presentation-of-passenger-lymphocyte-syndrome
#19
Thomas J Gniadek, Andrea M McGonigle, R Sue Shirey, Patricia A Brunker, Michael Streiff, Benjamin Philosophe, Evan M Bloch, Paul M Ness, Karen E King
BACKGROUND: Passenger lymphocyte syndrome occurs when donor lymphocytes are transplanted with a solid organ and produce alloantibodies that react with antigens on the recipient's red blood cells (RBCs). Typically, passenger lymphocyte syndrome presents as immunoglobulin G antibody-mediated, extravascular hemolytic anemia with reticulocytosis. Often, the donor was alloimmunized before transplantation. CASE REPORT: A 34-year-old Group O, D+ man with a negative antibody screen received a liver transplant from a Group O, D- donor...
May 2017: Transfusion
https://www.readbyqxmd.com/read/28366698/steroid-free-immunosuppression-is-associated-with-enhanced-th1-transcripts-in-kidney-transplantation
#20
Petra Hruba, Irena Tycova, Eva Krepsova, Eva Girmanova, Alena Sekerkova, Janka Slatinska, Ilja Striz, Eva Honsova, Ondrej Viklicky
BACKGROUND: Steroid avoidance in immunosuppression in kidney transplantation offers several metabolic advantages, however it is associated with higher early acute rejection rate. Cellular and molecular mechanisms of this phenomenon remain poorly understood. METHODS: In this single center observational study, low-risk kidney transplant recipients randomized into large multicenter prospective ADVANCE trial with steroid avoidance/early withdrawal and center standard of care treated patients were monitored for 12months...
March 30, 2017: Transplant Immunology
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