D. Sahoo, S. Anuragaa, A. Basavarajegowda, Rajendra Gurunath Kulkarni
Background and Objectives: In autoimmune hemolytic anemia (AIHA) patients, there is decreased survival of red blood cells (RBCs) because of increased destruction by patients' autoantibodies. Due to decreased survival of RBCs, there is an increase in erythropoiesis and other biochemical parameters of hemolysis. One of the vital tests in AIHA is direct Coombs test (DCT). In this study, we share our experience on the difficulties faced by us during the compatibility testing and providing transfusion support to these patients. Methods: This is a retrospective study done in the department of transfusion medicine in a tertiary care hospital of South India. Patients from January 2020 to March 2021 with the diagnosis of AIHA requiring transfusion were included in this study. A total of 136 patients with positive DCT with AIHA diagnosis requiring transfusion support were included in our study. Results: Out of 136 cases, 58% (n=79) of patients had incompatibility during cross matching while in 42% (n=57) had cross matched compatible unit. In all incompatible cases best match blood was transfused. Most transfusions were done for patients with DCT Grade 4+. Out of 45 patients with mixed AIHA, 40 (88.8%) patients required a transfusion (P < 0.05). Of that 104 patients with transfusion support, 66 (63%) were with primary AIHA and 38 (36.04%) with secondary AIHA. Conclusion: It is tough and challenging to get compatible units in AIHA patients. Best-matched blood is useful when transfusion becomes essential during life-threatening anemia.
{"title":"Transfusion challenges and use of best match blood transfusion in autoimmune hemolytic anemia patients: Experience from a Tertiary Care Hospital of South India","authors":"D. Sahoo, S. Anuragaa, A. Basavarajegowda, Rajendra Gurunath Kulkarni","doi":"10.4103/gjtm.gjtm_39_22","DOIUrl":"https://doi.org/10.4103/gjtm.gjtm_39_22","url":null,"abstract":"Background and Objectives: In autoimmune hemolytic anemia (AIHA) patients, there is decreased survival of red blood cells (RBCs) because of increased destruction by patients' autoantibodies. Due to decreased survival of RBCs, there is an increase in erythropoiesis and other biochemical parameters of hemolysis. One of the vital tests in AIHA is direct Coombs test (DCT). In this study, we share our experience on the difficulties faced by us during the compatibility testing and providing transfusion support to these patients. Methods: This is a retrospective study done in the department of transfusion medicine in a tertiary care hospital of South India. Patients from January 2020 to March 2021 with the diagnosis of AIHA requiring transfusion were included in this study. A total of 136 patients with positive DCT with AIHA diagnosis requiring transfusion support were included in our study. Results: Out of 136 cases, 58% (n=79) of patients had incompatibility during cross matching while in 42% (n=57) had cross matched compatible unit. In all incompatible cases best match blood was transfused. Most transfusions were done for patients with DCT Grade 4+. Out of 45 patients with mixed AIHA, 40 (88.8%) patients required a transfusion (P < 0.05). Of that 104 patients with transfusion support, 66 (63%) were with primary AIHA and 38 (36.04%) with secondary AIHA. Conclusion: It is tough and challenging to get compatible units in AIHA patients. Best-matched blood is useful when transfusion becomes essential during life-threatening anemia.","PeriodicalId":52961,"journal":{"name":"Global Journal of Transfusion Medicine","volume":"17 1","pages":"144 - 148"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74285460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. S. Smit Sibinga, S. Pahuja, Mujtaba Al-Lawati, S. Hussain
Disasters and emergencies do happen all over the world, both natural and human-made. It is important to carry out a gap analysis and a risk assessment before making plans for disaster and emergency preparedness at national, regional, and local levels. It is equally important to decide in advance what to do and how to react to such situation to restore the “business as usual.” The blood system is an integral part of the health-care system and should be ready to act when necessary – donor mobilization, triage, personnel, stock management, and distribution. In the hospital, one should have a plan and be prepared in advance to introduce priority setting, stock management, restricted transfusion practice, and communication. The article provides a list of recommendations to prepare for such expected and unexpected situation to mitigate as much as possible the deleterious consequences.
{"title":"Disaster and Emergency Preparedness: Role of the Blood Establishment and Hospital Transfusion Service in the Management","authors":"C. S. Smit Sibinga, S. Pahuja, Mujtaba Al-Lawati, S. Hussain","doi":"10.4103/gjtm.gjtm_56_22","DOIUrl":"https://doi.org/10.4103/gjtm.gjtm_56_22","url":null,"abstract":"Disasters and emergencies do happen all over the world, both natural and human-made. It is important to carry out a gap analysis and a risk assessment before making plans for disaster and emergency preparedness at national, regional, and local levels. It is equally important to decide in advance what to do and how to react to such situation to restore the “business as usual.” The blood system is an integral part of the health-care system and should be ready to act when necessary – donor mobilization, triage, personnel, stock management, and distribution. In the hospital, one should have a plan and be prepared in advance to introduce priority setting, stock management, restricted transfusion practice, and communication. The article provides a list of recommendations to prepare for such expected and unexpected situation to mitigate as much as possible the deleterious consequences.","PeriodicalId":52961,"journal":{"name":"Global Journal of Transfusion Medicine","volume":"41 1","pages":"109 - 114"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82472970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. Naikoo, S. Basu, Animesh Bajpayee, D. Mishra, S. Datta
Background and Objectives: The aim of this study was to compare three platforms side-by-side: Nageotte hemocytometer, flow cytometry (FC), and standard hematology analyzer for enumeration of residual white blood cells (rWBCs) in single donor platelets (SDPs) apheresis. Materials and Methods: This was a prospective observational study conducted in a tertiary care oncology center by evaluating 36 units of SDP that were collected and tested in parallel by three different methods for the enumeration of rWBCs. All tests were performed within 24 h of collection according to the manufacturers' recommended methods. Counting by the Nageotte hemocytometer was done by: rWBC/μl = (cells counted × dilution/gridded area volume [50 μl]) and FC calculation was performed by: rWBC/μl = (total beads × total number of leukocyte events/total beads acquired × total sample volume). Results: The number of rWBCs detected by FC was between 1 white blood cell (WBC)/μl and 8 WBCs/μl; whereas, those detected by Nageotte chamber were between 3 WBC/μl and 6 WBCs/μl. The range of rWBC detected by hematology analyzer was 100 WBC/μl to 270 WBCs/μl. There was no correlation observed between the results obtained in standard hematology analyzer with any of the other two methods. The concordance correlation coefficient was measured by kappa analysis and found to be 0.71 between hemocytometry and FC. Linear regression analysis also showed a moderate correlation (R2 = 0.42) between the two methods. However, the coefficient of variation was found to be 49.32% in Nageotte method compared to the 17.55% in FC (P < 0.001). Conclusion: FC followed by Nageotte chamber counting is a better method compared to the standard hematology analyzer for the enumeration of rWBCs. To overcome the cost of FC it is high time to explore the scope and feasibility of a centralized quality monitoring system in India for all leukoreduced blood components.
{"title":"Comparison of three methods for enumeration of residual white blood cells in single donor apheresis platelets: A pilot study from Eastern India as a part of quality monitoring process for leukoreduction","authors":"N. Naikoo, S. Basu, Animesh Bajpayee, D. Mishra, S. Datta","doi":"10.4103/gjtm.gjtm_30_22","DOIUrl":"https://doi.org/10.4103/gjtm.gjtm_30_22","url":null,"abstract":"Background and Objectives: The aim of this study was to compare three platforms side-by-side: Nageotte hemocytometer, flow cytometry (FC), and standard hematology analyzer for enumeration of residual white blood cells (rWBCs) in single donor platelets (SDPs) apheresis. Materials and Methods: This was a prospective observational study conducted in a tertiary care oncology center by evaluating 36 units of SDP that were collected and tested in parallel by three different methods for the enumeration of rWBCs. All tests were performed within 24 h of collection according to the manufacturers' recommended methods. Counting by the Nageotte hemocytometer was done by: rWBC/μl = (cells counted × dilution/gridded area volume [50 μl]) and FC calculation was performed by: rWBC/μl = (total beads × total number of leukocyte events/total beads acquired × total sample volume). Results: The number of rWBCs detected by FC was between 1 white blood cell (WBC)/μl and 8 WBCs/μl; whereas, those detected by Nageotte chamber were between 3 WBC/μl and 6 WBCs/μl. The range of rWBC detected by hematology analyzer was 100 WBC/μl to 270 WBCs/μl. There was no correlation observed between the results obtained in standard hematology analyzer with any of the other two methods. The concordance correlation coefficient was measured by kappa analysis and found to be 0.71 between hemocytometry and FC. Linear regression analysis also showed a moderate correlation (R2 = 0.42) between the two methods. However, the coefficient of variation was found to be 49.32% in Nageotte method compared to the 17.55% in FC (P < 0.001). Conclusion: FC followed by Nageotte chamber counting is a better method compared to the standard hematology analyzer for the enumeration of rWBCs. To overcome the cost of FC it is high time to explore the scope and feasibility of a centralized quality monitoring system in India for all leukoreduced blood components.","PeriodicalId":52961,"journal":{"name":"Global Journal of Transfusion Medicine","volume":"11 1","pages":"174 - 177"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84258717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background and Objectives: There is limited literature available on the alloimmunization rates among pregnant women in India. Our primary aim was to estimate the occurrence of irregular erythrocyte alloantibody (IEA) immunization amongst women attending our antenatal care (ANC) clinic and to guide our obstetricians for improved ANC as well as their fetal outcomes. Methods: A cross-sectional study was performed at the blood center in North India over 12 months. We recruited a total of 212 study participants. Antibody screening and identification were performed by using semi-automated column agglutination technology and commercially available 3-red cell antibody screen panel with reagent cards having anti-human globulin (AHG) (Ortho Clinical Diagnostics Inc., USA) and 11-red cell antibody identification panel with reagent cards having AHG (Resolve Panel A; Ortho Clinical Diagnostics Inc., USA) respectively. Once identified, the semi-quantitative doubling dilutions, i.e., serial titrations of the respective IEA were performed by the conventional tube technique to assess their potency. The association of various antibodies identified was analyzed using the Pearson's Chi-square test. Results: Of the 7248 pregnant women attending our ANC clinics, the antibody screening was requested for 212 cases. Out of these, 10.8% (n = 23/212) of women were positive and were sensitized both by active and passive immunization. Their average age (in years) was 27.6 ± 3.52 (20 to 34). The majority belonged to the Dehradun district of Uttarakhand. ABO system-wise, the most common type amongst the included subjects was A as recorded in 34.4%, followed by B (30.18%), O (24.12%) and AB (11.3%), respectively. Rh system-wise, nearly 47% (n=100/212) of subjects had Rh (D) negative blood group. Interestingly, amongst these 23 ANC cases with positive IAT, nearly 13% had a history of having received a blood transfusion. Conclusion: To sum up, the screening of majority of ANC in our hospital is restricted to Rh (D) negative pregnancies. Perhaps, more awareness among obstetricians regarding the universal screening of all ANC cases irrespective of their Rh (D) status is the need of the hour.
{"title":"Occurrence of erythrocyte alloimmunization in women attending antenatal care clinic","authors":"Heeya Gupta, A. Kusum, M. Raturi","doi":"10.4103/gjtm.gjtm_42_22","DOIUrl":"https://doi.org/10.4103/gjtm.gjtm_42_22","url":null,"abstract":"Background and Objectives: There is limited literature available on the alloimmunization rates among pregnant women in India. Our primary aim was to estimate the occurrence of irregular erythrocyte alloantibody (IEA) immunization amongst women attending our antenatal care (ANC) clinic and to guide our obstetricians for improved ANC as well as their fetal outcomes. Methods: A cross-sectional study was performed at the blood center in North India over 12 months. We recruited a total of 212 study participants. Antibody screening and identification were performed by using semi-automated column agglutination technology and commercially available 3-red cell antibody screen panel with reagent cards having anti-human globulin (AHG) (Ortho Clinical Diagnostics Inc., USA) and 11-red cell antibody identification panel with reagent cards having AHG (Resolve Panel A; Ortho Clinical Diagnostics Inc., USA) respectively. Once identified, the semi-quantitative doubling dilutions, i.e., serial titrations of the respective IEA were performed by the conventional tube technique to assess their potency. The association of various antibodies identified was analyzed using the Pearson's Chi-square test. Results: Of the 7248 pregnant women attending our ANC clinics, the antibody screening was requested for 212 cases. Out of these, 10.8% (n = 23/212) of women were positive and were sensitized both by active and passive immunization. Their average age (in years) was 27.6 ± 3.52 (20 to 34). The majority belonged to the Dehradun district of Uttarakhand. ABO system-wise, the most common type amongst the included subjects was A as recorded in 34.4%, followed by B (30.18%), O (24.12%) and AB (11.3%), respectively. Rh system-wise, nearly 47% (n=100/212) of subjects had Rh (D) negative blood group. Interestingly, amongst these 23 ANC cases with positive IAT, nearly 13% had a history of having received a blood transfusion. Conclusion: To sum up, the screening of majority of ANC in our hospital is restricted to Rh (D) negative pregnancies. Perhaps, more awareness among obstetricians regarding the universal screening of all ANC cases irrespective of their Rh (D) status is the need of the hour.","PeriodicalId":52961,"journal":{"name":"Global Journal of Transfusion Medicine","volume":"7 1","pages":"164 - 168"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84864169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Zdziarska, K. Chojnowski, A. Klukowska, P. Łaguna, M. Łętowska, A. Mital, W. Mlynarski, J. Musial, J. Treliński, A. Undas, T. Urasiński, J. Windyga, M. Podolak-Dawidziak
This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially. Management of von Willebrand disease. Recommendations of the Hemostasis Group of the Polish Society of Hematology and Transfusiology (2022)
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{"title":"Management of von Willebrand disease. Recommendations of the Hemostasis Group of the Polish Society of Hematology and Transfusiology (2022)","authors":"J. Zdziarska, K. Chojnowski, A. Klukowska, P. Łaguna, M. Łętowska, A. Mital, W. Mlynarski, J. Musial, J. Treliński, A. Undas, T. Urasiński, J. Windyga, M. Podolak-Dawidziak","doi":"10.5603/jtm.2022.0009","DOIUrl":"https://doi.org/10.5603/jtm.2022.0009","url":null,"abstract":"This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially. Management of von Willebrand disease. Recommendations of the Hemostasis Group of the Polish Society of Hematology and Transfusiology (2022)","PeriodicalId":52961,"journal":{"name":"Global Journal of Transfusion Medicine","volume":"61 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76687721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Summary Direct oral anticoagulants (DOACs) are used in Europe over a decade. One of their favourable properties is a stable prophylactic or therapeutic drug dose. Sometimes, however, it is preferred to use older antithrombotic drugs (vitamin K antagonists, heparins) or — in some clinical situations — to modify the standard recommended drug dose.
{"title":"DOAC — not for everyone, and sometimes at different dose","authors":"Jacek Musiał","doi":"10.5603/jtm.2022.0012","DOIUrl":"https://doi.org/10.5603/jtm.2022.0012","url":null,"abstract":"Summary Direct oral anticoagulants (DOACs) are used in Europe over a decade. One of their favourable properties is a stable prophylactic or therapeutic drug dose. Sometimes, however, it is preferred to use older antithrombotic drugs (vitamin K antagonists, heparins) or — in some clinical situations — to modify the standard recommended drug dose.","PeriodicalId":52961,"journal":{"name":"Global Journal of Transfusion Medicine","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84180508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dawid Makowicz, Renata Dziubaszewska, Katarzyna Lisowicz, Natalia Makowicz
Summary Background: Voluntary blood donation refers to ”unpaid, non-remunerated” donation of blood by healthy people for those who require blood transfusion. Recently in Poland, there is an observed decrease in the number of blood donations which, among others, may be ascribed to demographic changes and epidemics of various diseases but also to myths, prejudice and misconceptions regarding the act of donating blood. The most objective source of opinion on the subject are the donors themselves. The study aim was to explore the opinions of blood donors regarding the impact of regular blood donation on the human body as well as their experience related to blood donation. Material and methods: The method of a diagnostic opinion survey was used with a questionnaire developed for the purpose of the study. The questionnaire consisted of 6 closed-ended and 5 sociodemographic questions. It was completed by 2387 blood donors (responders). The IBM SPSS Statistics 20 program was used for predictive analytics and calculations. The statistical significance was established at p ≤ 0.05. Results: In the opinion of most responders (78.3%) one cannot get addictive to blood donation. The majority of blood donors (85.2%) believe that no increased production of red blood cells (RBCs) in bone marrow occurs as result of regular blood donations. As the greatest health benefit for the donor himself, 81.4% of the responders declared the boosted/enhanced sense of well-being as result of offering one’s own blood to other people. Conclusions: The knowledge and experience of voluntary blood donors should be carefully considered by organizers of blood-promotion campaigns. The conviction that no side effects are associated with long term blood donation gets stronger with the increase in the volume of donated blood. Altruism was the most frequently declared motive for donating blood.
{"title":"Impact of regular blood donation on the human body; donors’ perspective. Donors’ opinion on side effects of regular blood donation on human body","authors":"Dawid Makowicz, Renata Dziubaszewska, Katarzyna Lisowicz, Natalia Makowicz","doi":"10.5603/jtm.2022.0011","DOIUrl":"https://doi.org/10.5603/jtm.2022.0011","url":null,"abstract":"Summary Background: Voluntary blood donation refers to ”unpaid, non-remunerated” donation of blood by healthy people for those who require blood transfusion. Recently in Poland, there is an observed decrease in the number of blood donations which, among others, may be ascribed to demographic changes and epidemics of various diseases but also to myths, prejudice and misconceptions regarding the act of donating blood. The most objective source of opinion on the subject are the donors themselves. The study aim was to explore the opinions of blood donors regarding the impact of regular blood donation on the human body as well as their experience related to blood donation. Material and methods: The method of a diagnostic opinion survey was used with a questionnaire developed for the purpose of the study. The questionnaire consisted of 6 closed-ended and 5 sociodemographic questions. It was completed by 2387 blood donors (responders). The IBM SPSS Statistics 20 program was used for predictive analytics and calculations. The statistical significance was established at p ≤ 0.05. Results: In the opinion of most responders (78.3%) one cannot get addictive to blood donation. The majority of blood donors (85.2%) believe that no increased production of red blood cells (RBCs) in bone marrow occurs as result of regular blood donations. As the greatest health benefit for the donor himself, 81.4% of the responders declared the boosted/enhanced sense of well-being as result of offering one’s own blood to other people. Conclusions: The knowledge and experience of voluntary blood donors should be carefully considered by organizers of blood-promotion campaigns. The conviction that no side effects are associated with long term blood donation gets stronger with the increase in the volume of donated blood. Altruism was the most frequently declared motive for donating blood.","PeriodicalId":52961,"journal":{"name":"Global Journal of Transfusion Medicine","volume":"59 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86591610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Patient with bleeding diathesis in the emergency room: principles of management","authors":"J. Windyga","doi":"10.5603/jtm.2022.0010","DOIUrl":"https://doi.org/10.5603/jtm.2022.0010","url":null,"abstract":"","PeriodicalId":52961,"journal":{"name":"Global Journal of Transfusion Medicine","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80959571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Summary Acquired coagulation factor deficiencies are caused by inhibitory autoantibodies which are usually directed against clotting factor VIII (FVIII), causing acquired hemophilia A (AHA). Clotting factor inhibitors usually cause abnormalities in screening coagulation tests (activated partial thromboplastin time [aPTT] and/or prothrombin time [PT]). Other coagulation factor inhibitors are much rarer, particularly inhibitors to factor XI (FXI). We present the case of an 82-year-old woman referred to a hematological center for isolated aPTT prolongation in pre-surgery screening tests. No bleeding symptoms were reported either at admission or in the patient’s medical history. One stage coagulation factor assays revealed lower factor VIII, IX, XI, XII levels. The Nijmegen modification of the Bethesda assay showed the presence of an inhibitor to factor XI (22.1 BU/mL). No autoantibodies to coagulation factors VIII, IX and XII were found: inhibitor titers were all below 0.6 BU/mL. Acquired hemophilia C was diagnosed (the presence of autoantibodies to clotting factor XI).
{"title":"Laboratory work-up/diagnostics of acquired factor XI inhibitor","authors":"T. Iwaniec, J. Zdziarska, T. Sacha","doi":"10.5603/jtm.2022.0004","DOIUrl":"https://doi.org/10.5603/jtm.2022.0004","url":null,"abstract":"Summary Acquired coagulation factor deficiencies are caused by inhibitory autoantibodies which are usually directed against clotting factor VIII (FVIII), causing acquired hemophilia A (AHA). Clotting factor inhibitors usually cause abnormalities in screening coagulation tests (activated partial thromboplastin time [aPTT] and/or prothrombin time [PT]). Other coagulation factor inhibitors are much rarer, particularly inhibitors to factor XI (FXI). We present the case of an 82-year-old woman referred to a hematological center for isolated aPTT prolongation in pre-surgery screening tests. No bleeding symptoms were reported either at admission or in the patient’s medical history. One stage coagulation factor assays revealed lower factor VIII, IX, XI, XII levels. The Nijmegen modification of the Bethesda assay showed the presence of an inhibitor to factor XI (22.1 BU/mL). No autoantibodies to coagulation factors VIII, IX and XII were found: inhibitor titers were all below 0.6 BU/mL. Acquired hemophilia C was diagnosed (the presence of autoantibodies to clotting factor XI).","PeriodicalId":52961,"journal":{"name":"Global Journal of Transfusion Medicine","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76149725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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