Klinički značajno anti-Wra antitelo: prikaz dva uspešno vođena pacijenta
Sažetak
Uvod. Wra je antigen Dijego sistema krvnih grupa. Anti-Wra antitelo se može naći u serumu zdravih osoba (prirodno anti-Wra) ili može biti stimulisano imunski-posredovanim mehanizmima nakon transfuzije ili nakon izlaganja stranim eritrocitima tokom trudnoće. Komercijalni paneli za ideinfikaciju antitela rutinski ne sadrže Wra antigen pozitivne eritrocite. Prikazujemo dva slučaja transfuziološkog zbrinj-avanje pacijenata u kompleksnim okolnostima, kao što je pojava antitela na Wra antigen niske učestalosti. Prikaz bolesnika. Kod prvog prikazanog pacijenta, koji je više puta primio transfuziju, anti-Wra antitelo je otkriveno tokom rešavanja unakrsne nepodudarnosti. Kod drugog pacijenta je anti-Wra antitelo identifikovano tokom rutinskog skrininga antieritrocitnih antitela tokom trudnoće. Imunohematološko testiranje je uključivalo tipizaciju krvi i skrining antitela, test unakrsnog podudaranja, identifikaciju antitela, indirektni antiglobulinski test (IAT) i direktni antiglobulinski test (DAT). Tehnologija aglutinacije u karticama sa gel mikroepruvetama i standardna metodologija ispitivanja u epruveti korišćene su i u IAT-u i u DAT-u. Zaključak. Zbog ograničenja skrining testa u otkrivanju antitela na klinički značajne antigene krvnih grupa niske učestalosti, kao što je Wra, preporuka pri odabiru jedinica eritrocita za transfuziju jeste korišćenje jedinica čija je unakrsna podudarnost pokazana IAT-om na 37 ºC. U slučaju anti-Wra antitela, kao i u slučajevima drugih antitela na niskofrekventne antigene, imunohematološki nalaz treba da bude potvrđen u nacionalnoj ili međunarodnoj referentnoj laboratoriji koja raspolaže strukturom, organizacijom, kao i tehničkim i stručnim kapacitetima za obezbeđivanje ove usluge.
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