Multiple or uncommon red cell alloantibodies in women: association with autoimmune disease

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Abstract
BACKGROUND: Patients with multiple or uncommon red cell (RBC) alloantibodies require special efforts in the blood bank. This study investigated whether such persons had other immune‐related conditions that might help to explain or predict their propensity for RBC antibody formation.STUDY DESIGN AND METHODS: Charts were retrospectively reviewed of 29 men and 83 women with multiple (> or = 3) RBC antibodies of potential clinical significance, uncommon RBC antibodies (anti‐e, ‐ Kpb, ‐Jkb, ‐Fyb, ‐S, ‐U, ‐Yta, ‐Dib, ‐Ata), or both. The clinical features in 43 women with multiple antibodies were compared to those in two equal‐sized control cohorts of women matched for transfusion‐ related diagnoses, but having either one RBC antibody or none.RESULTS: Women with uncommon RBC antibodies had a 33‐percent (18/54) prevalence of autoimmune disease. Twenty‐eight percent of the 43 women with multiple antibodies had autoimmune disease, compared to 14 percent of women in the cohort with one RBC antibody (p = 0.09) and 7 percent of those in the cohort without RBC antibodies (p = 0.01). Only one of the 29 men had autoimmune disease.CONCLUSION: Autoimmune disease is a common underlying factor in women who make multiple or uncommon RBC alloantibodies of potential clinical significance.