Ex vivo antigen preparation for the serological detection of drug‐dependent antibodies in immune haemolytic anaemias

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Abstract
Summary. TWO patients with severe, intravascular haemolysis due to drug‐dependent antibodies are described. The antibodies were directed against presumptive metabolites of buthiazide (International Non‐proprietary Name, butizide) and nomifensine. Their detection was possible only in the presence of ex vivo antigens (i.e. fresh serum of volunteers after ingestion of the drugs) while in vitro antigen preparations yielded inconclusive results. Both antibodies lysed normal red cells in the presence of ex vivo antigens and complement. The buthiazide‐related antibody was IgG (subclass IgGl), the nomifensine‐related antibody was IgM. We conclude that the use of ex vivo antigens is of great importance in the serological evaluation of cases with suspected drug‐dependent immune haemolysis.