The immunohistochemical expression of von Willebrand factor, T-cadherin, and Caveolin-1 is increased in kidney allograft biopsies with antibody-mediated injury.

BACKGROUND: There are only a few reports evaluating the applicability of endothelial-damage markers analysis by immunohistochemistry (IHC) in kidney allograft samples. This study analyzed the expression of Caveolin-1 (Cav), von Willebrand factor (Vwf), and T-cadherin (Cad) in kidney biopsies and their association with antibody-mediated injury. METHODS: In this retrospective study, 114 cases with antibody-mediated changes (Banff, 2020) and 72 with interstitial fibrosis/tubular atrophy were selected. IHC for Cav, Vwf and Cad was performed and evaluated according to their qualitative expression in peritubular capillaries. The cases were grouped according to the presence of microvascular inflammation (MVI), donor-specific antibodies (DSA), C4d positivity and antibody-mediated rejection (AMR). A level of significance < 0.05 was adopted. RESULTS: Vwf expression was associated with MVI (p < 0.001), DSA (p = 0.016), C4d (p < 0.001) and AMR (p < 0.001), and was higher in DSA+/C4d+ cases despite MVI (p < 0.001). The expression of Cad correlated with MVI (p = 0.015), C4d (p = 0.005) and AMR (p = < 0.001). Cad was more expressed in chronic AMR compared with acute/active cases (p = 0.001). Cav expression was associated with MVI (p = 0.029) and AMR (p = 0.016) and was also higher in chronic AMR (p = 0.049). A combined score of Vwf and Cad was higher in AMR when compared with C4d without rejection and IF/TA cases (p < 0.001). CONCLUSION: Vwf, Cad and Cav expression shows association with antibody-mediated injury and may be helpful to support AMR diagnosis.

Isoantibodies, prevalence and risk factors in two hospitals in Mexico / Isoanticuerpos, prevalencia y factores de riesgo en dos hospitales de México

Background: Erythrocyte isoimmunization or alloimmunization is a late complication of transfusion, in which antibodies against erythrocyte antigens other than the ABO system are developed. Its prevalence is variable, groups of patients with low prevalence (2%) and others of high risk with more than 50% have been described. These antibodies can have serious clinical repercussions in transfused patients. Objective: To know the prevalence of erythrocyte isoimmunization, the risk factors for its development and the types of antibodies developed in the user population of two hospitals in Mexico. Methods: Retrospective study. The database of the Blood Bank and the Transfusion Service of two hospitals was analyzed for the search of transfused patients who developed isoantibodies from 2012 to 2016, analyzing their background to determine the risk factors, prevalence and type of antibodies. Results: An isoimmunization prevalence of 0.97% was found in 5 years; the main antibodies found were: anti-E, anti-K, anti-C, anti-Dia, anti-c, anti-D and anti-Fya. The associated risk factors for the development of isoimmunization were: transfusion history, pregnancy and female sex, as a finding it was found that group O is a protective factor. Conclusions: Erythrocyte alloimmunization in the population studied corresponded to a low prevalence. The main antibodies found were against Rh, Kell and Diego system antigens, with a different distribution than published in other international series. No previous report was found about the finding on group O as a protective factor for isoimmunization.

Introducción: la isoinmunización o aloinmunización eritrocitaria es una complicación tardía de la transfusión, en la cual se desarrollan anticuerpos contra antígenos eritrocitarios diferentes al sistema ABO. Su prevalencia es variable, se han descrito grupos de pacientes con baja prevalencia (2%) y otros de alto riesgo con más del 50%. Estos anticuerpos pueden tener repercusiones clínicas graves en los pacientes transfundidos. Objetivo: conocer la prevalencia de la isoinmunización eritrocitaria, los factores de riesgo para su desarrollo y los tipos de anticuerpos desarrollados en la población usuaria de dos hospitales en México. Métodos: estudio retrospectivo. Se analizó la base de datos del banco de sangre y del servicio de transfusión de dos hospitales para la búsqueda de pacientes transfundidos que desarrollaron isoanticuerpos del año 2012 al 2016, analizando sus antecedentes para determinar los factores de riesgo, prevalencia y tipo de anticuerpos. Resultados: se encontró una prevalencia de isoinmunización del 0.97% en 5 años; los principales anticuerpos encontrados fueron: anti-E, anti-K, anti-C, anti-Dia, anti-c, anti-D y anti-Fya. Los factores de riesgo asociados para el desarrollo de isoinmunización fueron: antecedentes transfusionales, embarazo y el sexo femenino, como hallazgo se encontró que el grupo O es un factor protector. Conclusiones: la aloinmunización eritrocitaria en la población estudiada correspondió a una prevalencia baja. Los principales anticuerpos encontrados fueron contra antígenos del sistema Rh, Kell y Diego, con una distribución diferente a lo publicado en otras series internacionales. No se encontró reporte previo acerca del hallazgo sobre el grupo O como factor protector para isoinmunización.

Frequências dos tipos sanguíneos e títulos dos aloanticorpos em felinos domésticos / Frequency of blood groups and titers of alloantibodies in domestic cats

A área da hemoterapia necessita de testes de compatibilidade sanguínea confiáveis, como a tipagem sanguínea, para se evitarem possíveis reações transfusionais, mas em felinos é também importante para se evitar a isoeritrólise neonatal. Transfusões sanguíneas realizadas entre felinos doadores e receptores que não possuem compatibilidade sanguínea podem refletir em reação transfusional aguda, particularmente severa quando o sangue tipo A é transfundido em um gato tipo B, pois geralmente este último possui altos níveis de aloanticorpos de ocorrência natural. Portanto, o conhecimento da frequência dos tipos sanguíneos da população de gatos de uma região pode auxiliar na determinação dos riscos de reações transfusionais e de ocorrência de isoeritrólise neonatal. Tais riscos podem ser prevenidos com a tipagem sanguínea em casos de transfusão. Foram coletadas 100 amostras sanguíneas de felinos para a realização da tipagem sanguínea com plasmas reagentes anti-A e anti-B conhecidas e titulações de aloanticorpos anti-A e anti-B dos plasmas armazenados. A distribuição das frequências dos grupos sanguíneos foi 96% de felinos com tipo sanguíneo A e 4% de felinos com tipo sanguíneo B, não sendo encontrado na amostra populacional de felino tipo AB. Há um grande risco de reação adversa através da transfusão sanguínea randomizada entre felinos não tipados previamente

Hemotherapy requires reliable blood compatibility tests, such as blood typing, to avoid possible transfusion reactions in cats. However, it is also important to avoid neonatal isoerythrolysis. When blood transfusions are performed between incompatible feline donors and recipients, they may develop acute transfusion reactions, especially severe when type A blood is transfused into a type B cat because it has high levels of anti-A alloantibodies. Therefore, knowing on the blood type frequency in feline population of some region can help to determine the transfusion reaction risks and the occurrence of neonatal isoerythrolysis. Addicionally, such risks may be prevented through blood typing, in cases of transfusion. One hundred feline blood samples were collected and anti-A and anti-B blood reagent typing tests were performed, plus titration of alloantibodies of stored plasma. These tests showed a 96% frequency of type A blood and only 4% of type B blood among tested cats. We did not find any AB type blood cat. There is a great risk of adverse reactions after random blood transfusions between non-typed cats

Frequências dos tipos sanguíneos e títulos dos aloanticorpos em felinos domésticos / Frequency of blood groups and titers of alloantibodies in domestic cats

A área da hemoterapia necessita de testes de compatibilidade sanguínea confiáveis, como a tipagem sanguínea, para se evitarem possíveis reações transfusionais, mas em felinos é também importante para se evitar a isoeritrólise neonatal. Transfusões sanguíneas realizadas entre felinos doadores e receptores que não possuem compatibilidade sanguínea podem refletir em reação transfusional aguda, particularmente severa quando o sangue tipo A é transfundido em um gato tipo B, pois geralmente este último possui altos níveis de aloanticorpos de ocorrência natural. Portanto, o conhecimento da frequência dos tipos sanguíneos da população de gatos de uma região pode auxiliar na determinação dos riscos de reações transfusionais e de ocorrência de isoeritrólise neonatal. Tais riscos podem ser prevenidos com a tipagem sanguínea em casos de transfusão. Foram coletadas 100 amostras sanguíneas de felinos para a realização da tipagem sanguínea com plasmas reagentes anti-A e anti-B conhecidas e titulações de aloanticorpos anti-A e anti-B dos plasmas armazenados. A distribuição das frequências dos grupos sanguíneos foi 96% de felinos com tipo sanguíneo A e 4% de felinos com tipo sanguíneo B, não sendo encontrado na amostra populacional de felino tipo AB. Há um grande risco de reação adversa através da transfusão sanguínea randomizada entre felinos não tipados previamente(AU)

Hemotherapy requires reliable blood compatibility tests, such as blood typing, to avoid possible transfusion reactions in cats. However, it is also important to avoid neonatal isoerythrolysis. When blood transfusions are performed between incompatible feline donors and recipients, they may develop acute transfusion reactions, especially severe when type A blood is transfused into a type B cat because it has high levels of anti-A alloantibodies. Therefore, knowing on the blood type frequency in feline population of some region can help to determine the transfusion reaction risks and the occurrence of neonatal isoerythrolysis. Addicionally, such risks may be prevented through blood typing, in cases of transfusion. One hundred feline blood samples were collected and anti-A and anti-B blood reagent typing tests were performed, plus titration of alloantibodies of stored plasma. These tests showed a 96% frequency of type A blood and only 4% of type B blood among tested cats. We did not find any AB type blood cat. There is a great risk of adverse reactions after random blood transfusions between non-typed cats(AU)

Domestic cats blood types frequency from Pará state, Brazil / Frequência dos tipos sanguíneos de gatos domésticos oriundos do estado do Pará, Brasil

In domestic cats, blood group AB consists of three blood types A, B and AB. A preliminary identification by typing technique is essential to minimize the occurrence of transfusion reactions and neonatal isoerythrolysis. Therefore, the aim of this study was to determine the frequency of blood types and estimate the probability of random transfusion reactions in domestic cats from Pará state, Brazil. Two-hundred thirty five animals were examined in Belém and Castanhal municipalities. Blood samples were collected by puncture of the cephalic or jugular vein, stored in EDTA tubes and refrigerated until analysis. The hemagglutination and reverse typing techniques were used to confirm the blood types of cats. Type A is the most frequently detected (98.3%), followed by type AB (1.28%) and B (0.42%). Likelihood of adverse reactions in random transfusion was 2.09%, with 1.67% mild to moderate and 0.42% potentially fatal. The results showed a higher frequency of A blood type and that the frequency of AB type was higher than B type. In conclusion, to know the frequency of the blood types according to geographic region minimizes the risk of transfusion reactions.

Em felinos domésticos, o grupo sanguíneo AB é constituído por três tipos de sangue A, B e AB. A identificação prévia, por meio da técnica de tipagem, é essencial para minimizar a ocorrência de reações transfusionais e isoeritrólise neonatal. Este estudo teve por objetivos determinar a frequência dos tipos sanguíneos e estimar a probabilidade de ocorrência de reações transfusionais aleatórias em gatos domésticos oriundos do estado do Pará, Brasil. Foram utilizados 235 animais domiciliados nos municípios de Belém e Castanhal. As amostras de sangue foram coletadas por punção da veia cefálica ou jugular, armazenadas em tubos com EDTA e refrigeradas até as análises. As técnicas de hemaglutinação e tipagem reversa foram utilizadas para confirmar os tipos sanguíneos dos felinos. O tipo A foi ao mais detectado (98,3%), seguido pelo tipo AB (1,28%) e B (0,42%). A probabilidade de ocorrência de reações adversas em transfusões aleatórias foi de 2,09%, sendo 1,67% leves a moderadas e 0,42% potencialmente fatais. Os resultados encontrados demonstram que na população de felinos estudada há uma maior frequência de gatos do tipo A e que a frequência do tipo AB foi maior que o tipo B. Em conclusão, conhecer a frequência dos tipos sanguíneos de acordo com a região geográfica minimiza o risco de reações transfusionais.

Domestic cats blood types frequency from Pará state, Brazil / Frequência dos tipos sanguíneos de gatos domésticos oriundos do estado do Pará, Brasil

In domestic cats, blood group AB consists of three blood types A, B and AB. A preliminary identification by typing technique is essential to minimize the occurrence of transfusion reactions and neonatal isoerythrolysis. Therefore, the aim of this study was to determine the frequency of blood types and estimate the probability of random transfusion reactions in domestic cats from Pará state, Brazil. Two-hundred thirty five animals were examined in Belém and Castanhal municipalities. Blood samples were collected by puncture of the cephalic or jugular vein, stored in EDTA tubes and refrigerated until analysis. The hemagglutination and reverse typing techniques were used to confirm the blood types of cats. Type A is the most frequently detected (98.3%), followed by type AB (1.28%) and B (0.42%). Likelihood of adverse reactions in random transfusion was 2.09%, with 1.67% mild to moderate and 0.42% potentially fatal. The results showed a higher frequency of A blood type and that the frequency of AB type was higher than B type. In conclusion, to know the frequency of the blood types according to geographic region minimizes the risk of transfusion reactions.(AU)

Em felinos domésticos, o grupo sanguíneo AB é constituído por três tipos de sangue A, B e AB. A identificação prévia, por meio da técnica de tipagem, é essencial para minimizar a ocorrência de reações transfusionais e isoeritrólise neonatal. Este estudo teve por objetivos determinar a frequência dos tipos sanguíneos e estimar a probabilidade de ocorrência de reações transfusionais aleatórias em gatos domésticos oriundos do estado do Pará, Brasil. Foram utilizados 235 animais domiciliados nos municípios de Belém e Castanhal. As amostras de sangue foram coletadas por punção da veia cefálica ou jugular, armazenadas em tubos com EDTA e refrigeradas até as análises. As técnicas de hemaglutinação e tipagem reversa foram utilizadas para confirmar os tipos sanguíneos dos felinos. O tipo A foi ao mais detectado (98,3%), seguido pelo tipo AB (1,28%) e B (0,42%). A probabilidade de ocorrência de reações adversas em transfusões aleatórias foi de 2,09%, sendo 1,67% leves a moderadas e 0,42% potencialmente fatais. Os resultados encontrados demonstram que na população de felinos estudada há uma maior frequência de gatos do tipo A e que a frequência do tipo AB foi maior que o tipo B. Em conclusão, conhecer a frequência dos tipos sanguíneos de acordo com a região geográfica minimiza o risco de reações transfusionais.(AU)

A case report of neonatal alloimmune thrombocytopenic purpura: the importance of correct diagnosis for future pregnancies

CONTEXTO: Púrpura trombocitopênica neonatal aloimune (PTNA) é uma doença neonatal caracterizada por aloimunização materna contra as plaquetas fetais, que apresentam antígenos herdados do pai. Podem ocorrer hemorragias cerebrais, levando à morte ou a anomalias neurológicas permanentes. RELATO DE CASO: Mulher saudável, de 30 anos, deu à luz, por parto cesariano na 36ª semana de gestação, seu primeiro filho. Com 10 horas de vida, o recém-nascido apresentou petéquias e contagem de 8 x 103 plaquetas/µl no sangue periférico; foi medicado com imunoglobulina e recebeu alta após 18 dias de internação, com 100 x 103 plaquetas/µl. A causa da trombocitopenia não foi elucidada na época. Um ano depois, a criança morreu de neuroblastoma. Como os pais desejavam outro filho, foram encaminhados para investigação da trombocitopenia. Genotipagem plaquetária e pesquisa de anticorpos antiplaquetários foram realizadas, mostrando total falta de concordância entre os sistemas HPA-1 do pai (HPA-1a1a) e da mãe (HPA-1b1b) e anticorpos anti-HPA-1a no soro da mãe. Concluímos que o primeiro bebê nasceu com PTNA. Por isso, na segunda gravidez, a mãe foi tratada com diversas infusões de imunoglobulina intravenosa. Foi realizado cuidadoso monitoramento por ultra-som, com resultados normais para mãe e feto durante a gravidez. O segundo bebê nasceu por cesárea às 39 semanas, apresentando 92 x 103 plaquetas/µl seis horas após o nascimento. As plaquetas do recém-nascido foram genotipadas como HPA-1a1b e o soro da mãe novamente mostrou anticorpos anti-HPA-1a. Não houve hemorragia. A terapia de infusão de imunoglobulina foi efetiva na prevenção da PTNA no segundo filho.

A case report of neonatal alloimmune thrombocytopenic purpura: the importance of correct diagnosis for future pregnancies.

CONTEXT: Neonatal alloimmune thrombocytopenic purpura (NAITP) is a neonatal disorder characterized by maternal alloimmunization against fetal platelet antigens inherited from the father. Intracranial hemorrhage leading to death or permanent neurological disability may occur in the fetus. CASE REPORT: A healthy 30-year-old woman gave birth to her first baby by cesarean after an uneventful 36-week pregnancy. Ten hours after birth, the infant presented severe petechiae, with platelet count of 8 x 10(3)/microl. The mother's platelet count was normal (180 x 10(3)/microl). The infant re ceived intravenous immunoglobulin and was discharged 18 days later, with platelet count of 100 x 10(3)/microl. The cause of thrombocytopenia was not elucidated at that time. One year later, the infant died of neuroblastoma. Since the parents wanted another child, they were referred for investigation of this thrombocytopenia. Platelet genotyping and platelet antibody screening were performed, showing total HPA-1 system mismatch between mother (HPA-1b1b) and father (HPA-1a1a), with anti-HPA-1a antibodies in the mother's serum. We concluded that the first baby was born with NAITP. Thus, in the second pregnancy, the mother was treated with several infusions of intravenous immunoglobulin. Careful ultrasound monitoring was performed, with normal results for mother and fetus throughout the pregnancy. The second baby was born by cesarean at 39 weeks, presenting 92 x 10(3) platelets/microl six hours after birth. The baby's platelets were genotyped as HPA-1a1b and the mother's serum again showed anti-HPA-1a antibodies. No clinical bleeding was observed. Intravenous immunoglobulin therapy was an effective treatment for preventing NAITP in the second baby.

Isotype immune response of IgG antibodies at the persistence and reactivation stages of human herpes virus 6 infection.

BACKGROUND: Infections with human herpes virus 6 (HHV-6) are very common. After primary infection, the virus remains latent and persists at low level in cells and tissues. Not usually associated with disease in the immunocompetent host, HHV-6 infection is a major cause of opportunistic viral infections in the immunosuppressed. The different stages of HHV-6 infection are difficult to characterize in the laboratory. OBJECTIVES: The aim of this paper was to assess the isotype patterns of IgG antibodies against HHV-6 in seropositive subjects during different stages of the virus activity. STUDY DESIGN: From a total of 190 human serum samples from 43 healthy children, 24 pregnant women and 24 patients with bone marrow transplants, 111 sera were processed by indirect immunofluorescence assay for the detection of IgG1, IgG2, IgG3 and IgG4 specific antibodies. The mean geometrical title (MGT) of the antibodies was calculated. RESULTS: All pregnant women had IgG1 (24/24; 100%; MGT 46). A 95% (41/43) of healthy infants had IgG1 (MGT 57). In bone marrow transplants, 58% (14/24) of the patients showed seroconversion (MGT 529) with an isotype response of IgG1 and IgG4 during the observation period. Remaining bone marrow transplant patients, who had the IgG without any variations (MGT 184), had isotype IgG1. CONCLUSIONS: These results revealed two different immune isotype response patterns. One of them is restrictive to IgG1 in the latent phase of HHV-6 infection in healthy children, pregnant women and transplant patients with stable levels of antibodies whereas IgG1 and IgG4 are detected in the reactivation of HHV-6 in transplant patients. The IgG isotype immune responses may contribute to the existing set of serological markers in characterizing the different stages of natural infection of HHV-6.

Detection of alloantibodies against non-HLA antigens in kidney transplantation by flow cytometry.

The presence of alloantibodies against human leucocyte antigen (HLA)-I and HLA-II antigens has been associated with hyperacute and accelerated graft rejections. However, occasionally these rejections occur in patients without donor-specific anti-HLA antibodies, suggesting the presence of other antigenic complexes that are shared by the graft and other cell populations. Usually, these antibodies are not routinely studied and their role in graft rejection is poorly understood. For this reason, we tested, by flow cytometry, the presence of panel-reactive alloantibodies (PRA) using different cell populations in 30 pre-transplant sera of kidney graft recipients. The patients studied had or had not hyperacute and accelerated rejection episodes (HARE) and did not have alloantibodies against HLA of their specific donors. We found that IgG and IgM alloantibodies directed against HLA-I antigens, different to the HLA-I antigens of the specific donors, as well as IgG against endothelium/monocyte antigens, IgM against platelets, and IgM against T cells are significantly associated with HARE, independently of the percentage of PRA. Our findings suggest that the detection of antibodies by flow cytometry against non-major histocompatibilty complex antigens may be useful as a pre-transplant crossmatch in living related donor kidney transplants to diminish the incidence of HARE.

The relevance of crossmatch and HLA compatibility in liver transplantation

Encontra-se bem definido o papel dos aloanticorpos HLA no desencadeamento da rejeicao hiperaguda nos transplantes renais. Nos casos dos transplantes hepaticos, assim como nos transplantes cardiacos, permanece controverso o papel de anticorpos pre-formados na sobrevida do enxerto. Realizamos neste estudo extensa revisao da literatura medica recente publicada pelos grandes centros mundiais transplantadores de figado a respeito da importancia do crossmatch e da compatibilidade HLA nos resultados precoces e tardios do transplante de figado. Ainda longe da unanimidade, a compatibilidade imunologica HLA parece exercer influencias nos desempenhos precoce e tardio dos enxertos hepaticos, apesar do avanco dos imunossupressores. Entretanto a baixa incidencia de paciente transplantados com altos titulos de testes de crossmatch positivos, nao altera a sobrevida global das casuisticas analisadas, sendo controversa sua utilizacao como metodo de selecao frente aos custos de seu emprego, mas nao excluindo seu valor como auxiliar na orientacao da imunossupressao precoce e tardia destes pacientes

Maternal immunization to Gov system alloantigens on human platelets.

BACKGROUND: Immunization to platelet alloantigens can occur during pregnancy or after the transfusion of blood components. Platelet alloantibodies can cause neonatal alloimmune thrombocytopenia and posttransfusion purpura. Transfusion-induced alloimmunization to a novel platelet alloantigen system, Gov, expressed on the 175-kDa glycosyl phosphatidylinositol-anchored platelet glycoprotein, CD109, was previously described. This report describes three unrelated patients who were alloimmunized to Gov(a) or Gov(b) during pregnancy. STUDY DESIGN AND METHODS: Platelets were typed by using radioimmunoprecipitation for HPA-1a, -3a, -5a, -5b, Gov(a), and Gov(b) and by polymerase chain reaction-restriction fragment length polymorphism for HPA-1a, -1b, -3a, and -3b. Maternal sera were screened for platelet antibodies by using radioimmunoprecipitation and the antigen capture assay. RESULTS: Patients 1 and 2 were investigated after the diagnosis of neonatal alloimmune thrombocytopenia in their children, and alloantibodies specific for Gov(b) and Gov(a), respectively, were detected in maternal serum. Serum from patient 3, who had mild idiopathic thrombocytopenia purpura with no detectable autoantibody, was found to contain alloantibodies to Gov(b) and to HPA-5b, presumably as a result of immunization during pregnancy. Platelet typings confirmed that the patients were at risk for alloimmunization to the respective antigen. CONCLUSION: This report of three cases of maternal alloimmunization to antigens in the Gov system indicates that immunization can occur via placental transfer of antigen and that Gov system alloantibodies may be associated with neonatal alloimmune thrombocytopenia.

Red blood cell alloimmunization in sickle cell disease: the influence of racial and antigenic pattern differences between donors and recipients in Brazil.

Red blood cell (RBC) transfusions are widely used in the management of patients with sickle cell disease (SCD). However, repeated RBC transfusions are often complicated by RBC alloimmunization. To investigate whether the frequency of RBC alloimmunization could be accounted for by racial and RBC phenotype differences between donors and recipients in Brazil, in this study we compared the RBC phenotype of 100 SCD patients with that observed in 120 randomly selected blood donors. A comparison of the RBC phenotype between the two groups revealed a statistically significant increase in the frequency of the C antigen in the donor population (P < 0.01), but no significant difference was observed for the A,B,D,c,E,e,K,k,Fya,M,N,S,s, and Jka antigens. Using standard techniques (indirect antiglobulin test, enzyme treatment, and low-ionic-strength solution) we observed an RBC alloimmunization rate of 12.9% (11/85) in the SCD patients. Fifteen alloantibodies were detected in 11 patients, and most (80%) involved antigens in the Rhesus and Kell systems. This observed RBC alloimmunization rate in SCD patients in Brazil is lower than that reported by studies from North America, suggesting that the requirement for extended antigen-matched RBC transfusion for SCD patients in the setting of a RBC phenotype concordant donor-recipient population may not be cost-effective in some countries.

Asociación de marcadores eritrocitarios (ABO, MNSs, Rh, Lewis, P1) con recurrencias y anomalías anatómicas y funcionales en niños con infección del tracto urinario / Association of erythrocyt markers (ABO, MNSs, Rh, Lewis, P1) with recurrences and anatomical-functional abnormalities in children with urinary tract infection

Para contribuir a la identificación de niños con infección del tracto urinario con mayor riesgo de ubicación alta o baja, recurrencias y alteraciones radiológicas o ultrasonográficas (complicaciones) se estudiaron las asociaciones entre éstas y la distribución de marcadores eritrocitarios (ABO, MNSs, Rh, Lewis, P1) en 309 casos de infección urinaria. No se encontró asociación entre algún polimorfismo eritrocitario en particular con las mencionadas categorías, pero si entre el fenotipo P1 y la etiología Escherichia coli (OR=3,07; IC 95 porciento=1,13 a 8,6; p<0,02) y la ausencia de etiología no E. coli con el fenotipo B+(0/26) sin llegar a niveles de significación. Estos hallazgos sugieren que en niños con infección urinaria, estos fenotipos, por separado, probablemente tienen acciones independientes y aditivas

Heparin-induced thrombocytopenia in a child.

We describe a case of thrombocytopenia and deep venous thrombosis in a boy who received heparin to maintain patency of a central venous catheter. Measurement of the release of serotonin labeled with carbon 14 confirmed the presence of heparin-induced thrombocytopenia. Children receiving heparin therapy should be monitored for the possibility of heparin-induced thrombocytopenia.