Anti-C and anti-e were identified in our patient and his DAT was 3+positive for IgG without previous transfusion history. 

His RBCs were typed as R1R2. Therefore, we suspect that auto-anti-C+e were present in his blood.

I heard his antibodies could be autoantibodies mimicking anti-C and anti-e.

Does anyone know the concept of autoantibodies mimicking specificity and the effective method to differentiate from just autoantibodies in detail?

Any help would be appreciated.

Thanks

 

Edited February 9, 20187 yr by Matthew Kim

Most warm auto-antibodies have a specificity within the Rh Blood Group System, although some others, more rarely, have a specificity outside of this system, such as auto-anti-Wr^b.

Most of the auto-antibodies from within the Rh Blood Group System mimic anti-e, anti-E, anti-C, anti-c or a combination (or even a compound antibody, such as anti-Ce or anti-Rh7), but, in reality, they are actually weak forms of anti-Rh17 and/or anti-Rh18, although strong examples are not unknown).  As they are usually mimicking antibodies, they can usually be adsorbed out with red cells that do not actually express the actual antigen on their surface (for example, an apparent anti-e can be adsorbed out using R₂R₂ red cells).

PLEASE DO NOT try to identify them yourself, as the actual specificity is not significant, but will take an awful lot of time and you will require some VERY rare red cells, such as Rh_null, D--/D-- and the like, and these should be reserved for when they are required to identify the specificity of rare allo-antibodies, such as anti-Hr, anti-Hr^B or anti-Rh29, where a true specificity may well be vital to identify.

In contrast, most "cold" auto-antibodies are true specificities.

For more information, you would find it hard to beat reading, Petz LD and Garratty G.  Immune Hemolytic Anemias, 2nd edition, Churchill-Livingstone, 2004, although I would advise you to be selective, as it is a very detailed book!

Thank you, Malcolm

I admire you clear answer.

I also appreciate your recommendation on the book, Immune Hemolytic Anemias. I will definitely read it.