Characterisation of Autoantibodies to Erythrocytes in Autoimmune Haemolytic Anaemia by Chloroquine

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Abstract
Chloroquine splits autoantibodies from erythrocytes of patients with autoimmune hemolytic anemia in vitro. After the removal of chloroquine from the samples, the autoantibodies can be identified in the eluates. With 1 exception, the autoantibodies of patients with idiopathic autoimmune hemolytic anemia (AIHA) and severe hemolysis were completely split from the cells; the autoantibodies of patients with symptomatic AIHA and moderate anemia, of patients with diseases unrelated to hemolysis, and of healthy persons, were not completely split from the erythrocytes. Autoantibodies, which are associated with severe hemolysis, were more easily split from the red cells by chloroquine. The eluted IgG [immunoglobulin G] incomplete warm autoantibodies were only in part specific to Rh antigens. The Rh specificity does not correlate with the absence or presence of increased hemolysis. The inhibition of the autoantibodies and the splitting or loosening of the antigen-antibody linkage within the immunocomplex by chloroquine could be responsible for a longer survival of autoantibody-coated red cells in patients with AIHA.