Further Studies on the Relationship of Anti‐Ena and Anti‐Wrb in Warm Autoimmune Hemolytic Anemia

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Abstract
The red blood cell eluates of 2 patients with warm autoimmune hemolytic anemia (AIHA) had anti-dl and anti-Wrb in a study of 150 individuals with positive AHG [antihuman globulin] tests. Of the AIHA cases, 39% had anti-Wrb as part of the autoantibody specificity. The eluates of these 2 patients were of interest since they showed weaker reactions with En(a-) cells than with En(a+), Wr(a+b-) cells. Absorption of the eluates confirmed a 2nd component that reacted with the En(a+), Wr(b-) cells but not the En(a-) cell, interpreted as autoanti-Ena. In 1 case anti-Ena was recovered from the En(a-) absorbing cell although these cells were not agglutinated by the autoantibody. This effect was not due to polyagglutinability, the Matuhasi-Ogata phenomenon or the decreased sialic acid content of the En(a-) red blood cell membranes and remains unexplained.