Development of Rh‐Specific Maternal Autoantibodies Following Intensive Plasmapheresis for Rh Immunisation during Pregnancy

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Abstract
Two cases of autoantibody formation following large volume plasmapheresis for rhesus immunisation during pregnancy are described. In each case the autoantibody was directed against the Rh complex but showed a preference for G‐positive cells. It is postulated that repeated plasmapheresis in the presence of persistent antigenic stimulation has removed a feedback inhibition of the immune response. The specificity of the alloantibody has broadened resulting in cross‐reactivity against self‐antigens. The possible implications of these cases in relation to autoimmunity are discussed.