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Cell
Antigens
of
and
Some
Red
Cell
Cell
By
Specialization.
Antigens
J.
JORGE
H.
of
YUNIS
Normoblasts
J.
EDMOND
AND
Demonstration
Human
Yuicis
I
N a previous
communication,1
it was reported
that
A, B and
H
receptors
are present
on human
normoblasts.
These
receptors
were
to be present
on the surface
of n’ormoblasts
in all stages
of development.
findings
suggested
that cell antigens
appear
early in cell formation.
In
the
present
number
of
ports
cell
preliminary
and
and
study,
red
we
results
reticulocytes
report
isoantigens
by
the
oti
of
the
antibodies
of erythroblastosis
results
of the
human
determination
normoblasts.
of
in
in
of
autoimmune
cases
of
vivo
a large
paper
This
detecior
antigen
shown
These
coating
of
also
re-
normoblasts
hemolytic
anemia
fetalis.
MATERIALS
Preparation
of nucleated
cell surpen.rion
( 1-3 ml. ) were obtained
by sternal
cyte
sedimentation
rates
( more
than
25
of fresh
pies
sexes
ranged
between
Versenate
des
material
at
25
were
were
(1
Disodium
remaining
tubes
41
C.
was
At
the
removed,
then
(EDTA-saline)
mg.
three
76
per
years
ml.
allowed
end
and
washed
and
of
the
of
to
this
with
from
in
60
All
age.
bone
the
) . The
1 #{189}to
fat
isotonic
saline
) . The
marrow
for
rich
patients
minutes
marrow
plasma
Thirty
adult
bone
marrow
sediment
period,
marrow
times
mm.
of
marrow:
hone
aspiration
2
in
cells
containing
removed
bone
was
1 mg.
of
both
collected
Wintrobe
remaining
samerythro-
from
were
were
hours
in nucleated
marrow
high
individuals
samples
particles
and
bone
with
in
and
the
hematocrit
marrow
parti-
separated.
The
Versenate
Disodium
cells
ml. and centrifuged
at 600 C. for 2 minutes.
Following
this, the supercompletely
and the suspension
restored
approximately
to its original
volume
in EDTA-saline
solution.
Only those specimens
free of microscopic
agglutinates
and
containing
15 or more normoblasts,
and approximately
30 erythrocytes
and/or
reticulocytes
natant
per
was
removed
per
100 nucleated
cells
were
used
in the present
study.
Preparation
of nucleated
cell sus-pension
of bone nwrrow
from immune
hemolytic
anemia
patients:
Approximately
2 ml. of bone
marrow
was
aspirated
from
the
tibia
of a newborn
infant
with anti-Rh0
erythroblastosis
and
from
the
iliac
crest
of a 13-year-old
patient
with
autoimmune
hemolytic
anemia.
(Cases
1 and 2) The
nucleated
cell suspensions
were
prepared
in
identical
Preparation
one
patient
Disodium
manner
to
of reticulocyte
that
described
above.
rich cell suspenaion:
with
anti-Rh0
erythroblastosis.
(Case
(1 mg.
per ml. of blood).
The
blood
hematocrit
tubes
at 25 C. At the end
Wintrobe
fuged at 600 C. for
10
minutes.
The
red
saline.
After
this, four per cent red cell
Antisera: The AB serum
was prepared
anti-B,
non-agglutinating
anti-D,
anti-C,
cell
from
blood
(5
blood
was
The
was
of
allowed
this
in
a
to
period,
was
button
suspensions
anti-E,
Venous
2)
then
was
washed
for
3 hours
AB
was
3 times
were
in
in
4
centriEDTA-
prepared.
healthy
anti-N
from
in Versenate
supernatant
EDTA-saline
anti-M,
obtained
collected
sediment
the
non-secretor
anti-c,
ml.)
donor.
and
antiLub
Anti-A,
and
This study
has been supported
in part by a NIH Grant No. 1 SO1-FR-05085,
arid in part
a grant from the Minnesota
Heart
Association.
From the Department
of Laboratory
Medicine,
University
of Minnesota,
Medical
School,
Minneapolis,
Minn.
Submitted
Dec. 24, 1963; accepted
for publication
Mar. 23, 1964.
by
522
BLOOD,
VOL.
24,
No.
5 (N0vEMBEII),
1964
From www.bloodjournal.org by guest on June 15, 2017. For personal use only.
RED
CELL
ANTIGENS
OF
globulin
anti-human
HUMAN
were
obtained
commercially.
anti-s,
antiTja,
and anti-P
antibodies
Memorial
Blood
Bank of Minneapolis.
antiLeb,
antiJka,
anemia),
anti-Jk”
were
complement
and
obtained
were
patients
by
The
were supplied
The complete
( from a patient
anti-I
from
inactivated
523
NORMOBLASTS
at
the
the
anti-e,
by Mrs.
anti-D,
with
acquired
University
addition
of
anti-K,
antiFya,
anti-S,
the War
anti-Lee,
Jane Swanson
from
the anti-k,
antiFyb,
of
autoimmune
Minnesota
1 mg.
of Versenate
to the
hospital
hemolytic
Hospitals.
AU
Disodium
per
sera
ml.
of
with
a
serum.
Case
Histories
Case
if-This
recent
history
loss,
Ten
idiopathic
days after
is a 13-year-old
of
sore
throat
thrombocytopenic
admission,
the
hours, and remained
after admission.
From
per
cent
and
and
came
a past
purpura
hemoglobin
4.3-5.5
August
a low
reached
who
history
of
on August
cleft
under
Methods.
bilateral
direct
antiglobulin
test
1960.
in 48
per
weeks
Cm.
cent
negative
when
with
contain
using
positive
during
the
cold
third,
fourth
count
The
it reacted
all
at
4, 25
some
erythrocytes.
The
of the
molytic
later,
and
Case
sucrose
C.
as an
was
made.
indirect
the
211-The
tests
patient
was
a
range
in
agglutinating
of
of
were
the
gave
a 3+
re-
was
shown
to
reactivity
of
globulin
giving
the
patient’s
fraction
it reacted
agglutination
count
and
weighing
he
of
crisis
and the
was
reticulocyte
negative
newborn
and
3+
reaction
and
more
that
strong-
The specificity
of the antibody
was tested
including
ii cells,
pp cells,
and
Bombay
reticulocyte
cent,
a
This
patient
and
and
per-
as described
serum.
75
1
storage
normal
revealed
study
the
antibody,
producing
5, his
a
of thermal
diagnosis
of “hypoplastic”
with steroids
was started
per
iron
day
the
below
aspirated
processed
centrifugation
present
reaction.
erythrocytes,
Treatment
Coombs
gradient
was
capable
findings,
a wide
of
and
serum.j
serum
fifth
always
marrow
same
antiglobulin
The
and
was
bone
the
globulin
serum.
activity
of his anemia.
On October
hemoglobin
was 7.0 Cm.
his
direct
antibody
was
A
the antiglobulin
of group
0
hematologic
anemia
provement
37
spectrum
possessing
antibody
and
ly at 37 C. when using
against
a large
number
view
test.
the
on
non-gamma
globulin
agglutinin
Coombs
that
performed
a broad
anti-human
gamma
indirect
showed
with
an
anti-human
an autologous
serum
studies
performed
hearing
at age 3, and hemolytic
crises in 1959 and
dropped
from
12.4 to 5.6 Cm. per cent
19 to August
28 the reticulocyte
of 0.2 per cent
on August
23.
Immunohematologic
8, 1963
palate,
23
moderate
centage
a
between
boy
fever
showed
some
features
consistent
with
hemolysis
( increase
erythrophagocytosis
) , but also
showed
normal
cellularity
of normoblasts.
A portion
of the bone marrow
specimen
was
August
was
action
and
28.6
count
was
2490
was
discharged
Cm.,
all
cells
per
cent.
8.2
In
to
heim-
Two
per
from
admitted
tested.
of autoimmune
patient
showed
days
cent,
the
the
the
hospital.
University
14 hours
of age.
On
admission,
the
patient
had a
total
bilirubin
of 12.2
mg. per cent,
a hemoglobin
of 11.7 Cm.
per
cent
and
a white
cell
count
of 20,050
per mm.3 with 32 normoblasts
per 100 white
cells. The reticulocyte
count
was 23 per cent. A bone marrow
study
showed
moderate
hyperplasia
with
35 per cent
normoblasts
in the differential
count.
A portion
of the bone
marrow
specimen
was
processed
Hospital
because
as described
tive,
and
the
of
marked
under
Methods.
direct
Coombs
erythrocytes
contained
A, Rh negative,
and
#{176}OrthoFoundation,
f Reported
with the
Hyland
Laboratories,
§Performed
versity
jaundice
by
of
Minnesota.
PlReported
with
The
test
anti-Rho
the
newborn
gave
the kind
The
Angeles,
C.
test
of I)r.
eluate
mother’s
a 4+
William
as group
obtained
erythrocytes
reaction.
A, Rh
from
the
posi-
infant’s
were typed
The maternal
as group
anti-Rh
Medicine
the
Krivit.
Calif.
Williams
permission
The
gave
typed
were
reaction.
Coombs
Raritan,
N. J.
kind permission
Ralph
erythrocytes
a 4+
specificity.
indirect
Los
Dr.
at
of
of
Dr.
the
John
Dept.
of
Anderson.
Internal
of
Uni-
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524
Arrr yurci
YUNIS
titer
was
found
exchange
to
be
transfusions
1 :256.
Because
on two
occasions
the
total
bilirubin
were
level
necessary
rose
before
over
17
mg.
the
discharging
per
cent,
patient.
METHODS
The
agglutination
methods
used
varied
according
to
the
different
testing
antisera.
The
slide direct
agglutination
method
was
used1
with
the
antisera
containing
an agglutinating
antibody
reacting
at 25 C. and with an avidity
of 120 seconds
or less
{anti-Rho(D),
antiTja, anti-M,
anti-N,
and anti-I].
The other
isoantigens
were
tested
using
the tube
method:
0.1
One
ml.
drop
of
a 10 x 75 mm.
supernatant
to
tube.
removed
each
nucleated
cell
All tubes
were
by
experimental
at room
equal
volume
lowed
by
used
of
[anti-(
22
per
incubation
37
able by the antiglobulin
washed
three
times with
antiglobulin
Each
to
as
Each
of
mixture
the antiglobulin
testing
serum
followed
od after the incubation
were
centrifuged
drop
of
was
cells
ferential
counts
reaction
was
glutinated
50
than
per
25
the
saline
washed
patient
0.1
of
with
of
the
absorbed
cell
suspension
ever,
addition
aThe
the
positive
free
or
antiglobulin
non-agglutinating
serum
thoroughly
When
serum
isoantigens
25
added
incubated
albumin
ag-
resuspended
testing
C. for
in
was
tested
the
in
saline
was
and
minutes.
technic,
at
were
sensitized
foldetect-
cells
5 minutes
an
added
with
were
human
EDTA-saline.
then
of
the
least
75
examined
was
examined
results
cent
the
normoblasts
were
per
cent
of
and
counts
of
with
the
strength
of
a positive
and
erythrocytes
were
reaction
paper.
erythrocytes
compared
The
fluid
microscopy.
differential
normoblasts
( 3), at least
25
( 1 ) , a negative
normoblasts
of blotter
with
for
one
excess
phase
of normoblasts
of
any
a piece
under
described.1
number
resuspended;
and
agglutinated
previously
per
gently
with
and
normoblasts
total
were
a coverglass
coverslide
These
as
cells
under
wax
agglutinates.
to the
6 different
tested
gave
the
a slide
reactions
nucleated
cells
hemolytic
anemia)
serum.
in
each
and
antihuman
equal
in
at
the
that
was
and
on
samples
the
suspension,
amounts
difag-
agglutinated
the
normoblasts
( 0 ) , was
read
(4)
(2),
as lack
of
was
the
1 per
absorbed
cent
absorbed
antibody.
brilliant
with
10
was
the
The
erythroblastosis
fetalis
One 0.1 ml. of EDT.Aerythroblastosis
fetalis,
and a
with
in
x 75
to
consisted
nucleated
that
used
antiglobulin
cresyl
washed
group
The
and
were
mixture
of
erythrocytes
the
mixed
reticulocyte
marrow.
used
0 Rho
with
was
the
bone
to
above,
serum
of
the
added
described
suspension
reaction
for
serum
blue.
tubes
that
of AB
cell
antiglobulin
to
mm.
identical
controls
tube,
of
anemia:
patient
negative
similar
a case
placed
procedure
the
a way
and
anti-Rho
The
globulin.*
in
of
serum
a
were
test
gamma
serum
(from
in a second
performed
antiglobulin
of
presence
globulin
modification
with
of
normoblasts
and reticulocytes
in
in a case of autoinunune
hemolytic
marrow
cell
testing
placed
all the
cell types.
any
antihuman
nucleated
as
the
of
of autoimmune
ml.
minute
placed
of
: When
Testing
of coated
of normoblasts
of
60
the
at least
antigens
of the
two
one
then
control
cent
of
for
according
cent
per
agglutination
with
present
follows
of
was
and
completely
this
with
testing
for
ml.
With
washings
read
one
of
0.15
incubated
pressure
applied
over
sealed
with
Kroening
classified
as
least
C.
were
Each
nucleated
and
and
ml.
were
marrow
2 minutes
mixed
C.
Many
1 ).
for
37
cells
minutes.
by three
was
gentle
were
reactions
at
then
(table
EDTA-saline
suspension
reticulocytes.
less
60
reaction
at 600
the
removed
by
preparations
Positive
at
for
or
0.15
were
the
bone
for
C.
of
antiserum
and
human
sera selected
according
negative
reactions
servexperiment
was
accompanied
additionally
with
a negative
control
of nucleated
cells
and
AB serum.
The control
of the antibodies
rereaction
consisted
of the addition
of AB serum
in the place
of the
by the antiglobulin
reaction.
\Vhenever
using the tube typing
methperiod
or after the addition
of antiglobulin
serum,
all cell mixtures
quiring
The
albumin
followed
controls.
consisting
Amounts
and
marrow
sample
served
erythrocyte
typing
so at least
the
ing
serum,
bone
cells
C.
fresh
at 600
C. ) for 5 minutes
c ) and
anti-sl
cent
at
pipette.
The
(25
were
of
centrifuged
capillary
tube.
temperature
glutinins
suspension
How-
prepared
cells
and
by
anti-
sensitized
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RED
CELL
ANTIGENS
globulin-brilliant
at
350
C.
OF
hUMAN
cresyl
for
one
blue
minute.
was
The
glutinates
and air-dried
with Wright-Giemsa
and
525
NORMOBLASTS
incubated
cells
at
were
25
then
C.
for
10
resuspended
smears
were
made.
The
examined
for the presence
minutes
and
then
centrifuged
to
produce
small
completely
preparations
were
then
counter-stained
suitable
for
ag-
of reticulocytes.
RESULTS
Nineteen
There
were
of the
nineteen
Classified
of
group
as
Rh0,
rh’,
so
rh”,
the
hr’
and
cleated
cell
suspension
cell
that
which
Because
for
reactions
genotypes
of the
specific
the
white
2 to 8 per
serum
with
for
cells.
cent
the
1 also
anti-Tj”,
anti-M,
attempts
velopment.
early and
Results
kk,
and
anti-N,
However,
the
late forms
of the
of the antigkilnilin
antigen,
and
the
the
anti-
a control
the
tested
with
of
nuanti-
nucleated
iso-antibodies.
to
sera
the
It
those
of
considered
with
from
are
antigens
other
the
specific
known
same
rare,
antisera
cells
to give
individual
However,
only
of a large
number
of the
and
strength
reactions
of avidity
that
and
the
negative
only
con-
of negative
studied.
showed
in
the
consisted
erythrocytes
counted
cells.
and
made
state
control.
with
then
were
LuaLua
normoblasts
cells
results
being
reaction,
similar
and
and
care
)
C
(C )
different
reactions
Lub
or as free
the
rh’(
reactions
with
positive
homozygous
studied
reactions
of normoblasts,
the strongest
antibodies
the
and
and
two
a negative
antiglobulin
serum
serum
hr”
anti-rh’
agglutination
ii and
agglutination
were
always
the
AB
hr’,
classi-
obtained.
AB serum
of nucleated
shows
was
obtained
I and
white
be seen
that
agglutinating
tested
hr’
as
for
the
The
corresponding
The
in the
AB
K,
agglutinates
produced
Table
It can
taining
was
Tj8,
counts
present
marrows
with
pp,
of
6 isoantigens,
erythrocytes
marrow
reactions
obtained
are
No
the
rl,
both
erythrocytes.
the
bone
differential
as part
Tj
with
Rho,
at least
agglutination
results
were
positive
negative;
for
with
positive.
(e )
hr”
and
serve
Four
Rh0
samples
three
of the
bone
give
the
the
results
in the
results
The
the
marrow
would
with
were
(c )
requiring
mixed
different
of negative
negative
trols
was
of
present
grounds
marrow
fifteen
rl
study.
B individuals.
hr’
and
,
homozygous
tested
cases
)
antigens
was
bone
the
antigen
was
normoblasts
isoantigens
the
allele
individual
globulin.
1 summarizes
shows
from
the
in those
suspensions
on
tested
Each
antisera.
human
Table
and
was
group
and
rh’ ( C
positive
,
positive,
suspension
serum,
negative
hr”
if the
two
Rh phenotypes,
of testing
were
A, and
Rh0
Rh,,
(D )
Rh0, rh’, hr”
for
of AB
suspensions
group
individual
cases
cell
(c )
and
serum
example,
nucleated
their
Seven
three
Each
in many
For
hr’
:
cell
seven
were
to
follows
negative;
that
nucleated
0,
individuals
negative.
taken
30
according
fled
rh”(E)
rh’
out
ten
white
the
erythrocytes
the
of the
seen
than
varied
reactions
of white
present
reactions
and
agglutinates
were
of less
cells
positive
with
not
for
between
the
anti-
cells.
agglutination
reactions.
with
the antisera
con120 seconds
(anti-Rh,,,
anti-I).
to study
the
examination
nucleated
reaction
normoblasts
of
red
of
cells
the
in different
agglutinated
of the
normoblasts
stages
cells
bone marow.
of erythroblastosis
of dedisclosed
fetalis
From www.bloodjournal.org by guest on June 15, 2017. For personal use only.
526
YUNIS
Table
1.-Qualitative
K k, Le”
Demonstration
of Rh#{176}
rh’ rh” hr’ hr”,
Fya Fyb, IKe 1Kb,
Lub,
and I Antigen
on Human
Normoblasts
Leb,
Method
Used
AND
YUNIS
M N S s, Tj”
Receptors
Nucleated
P1,
Cell
Tested
Suspension
Anti-
.
Incubation
T C
Antibody
Degree
globulin
Positive
Negative
of Agglu-
Time
reaction
Titer
reaction
reaction
tination
60’
yes
1024
2/2
3/3
3
4/4
2/2
1/1
2/2
4/4
3/3
3/3
2/2
3/3
1/1
3
2
1
2
3
Antl-Rh#{176}(D)
Non-agglutinating
37
AntiRh0(D)
Agglutinating
25
5’
Anti-rh’(C)
Agglutinating
37
60’
Anti-rh”(E)
Agglutinating
37
60’
Anti-hr’(c)
Non-agglutinating
37
60’
Anti-hr”(e)
Anti-M
Anti-N
Anti-S
Agglutinating
25
5’
Agglutinating
25
5’
-
Agglutinating
Agglutinating
25
37
5’
60’
-
Anti-s
Non-agglutinating
37
60’
Anti.Tj’
Agglutinating
4
5’
-
Anti-Pi
Anti-K
Agglutinating
Agglutinating
25
25
5’
5’
-
Anti-k
Non-agglutinating
37
60’
yes
51 2
Anti-Lee
Non-agglutinating
37
60’
yes
16
Anti-Le”
Non-agglutinating
37
130’
yes
S
1/1
3/3
2
AntiFy*
Anti-Fy”
Non-agglutinating
Non-agglutinating
37
37
60’
60’
yes
yes
64
256
2/2
2/2
3
2/2
2/2
2
Anti-JK’
AntiJKb
Non-agglutinating
Non-agglutinating
Agglutinating
Agglutinating
37
37
25
25
60’
60’
60’
5’
yes
yes
64
1/1
2/2
2
-
32
8
2/2
2/2
1/1
0
2
2
-
32
5/5
0
4
Anti-Lu”
Anti-I
and
autoimmtsne
f eta&:
The
marrow
incubation
were
was
Table
and
2 shows
served
or
as
with
--
ii
5/5
4/4
3
16
32
4/4
2/2
5/5
1/1
3
2
64
1/1
2/2
2
16
32
3/3
2/2
16
1/1
0
2/2
5/5
2
1
2
5/5
0
3
2/2
2/2
1
-
yes
-
and
of
reticulocytes
of nucleated
as
part
the
results
of
and
cell
of
of
for
the
agglutinates
the
as
hemolytic
of human
marrow
at 37
antiglobulin
bone
studied
C. These
after
tests
reactions
of
the
fetalis.
difFerential
counts
and
cells
white
a result
of
anemia
(fig.
It demonstrates
that
negative
agglutination
erythroblastoals
suspensions
erythroblastosis
erythrocytes
autoimmune
blastosis
fetalis.
on grounds
of
controls
anemia
of normoblasts,
patient
-
yes
anemia
reaction
hemolytic
counted)
-
performed
on 12 of the 19 samples
of bone
of the sample
with
AB serum
for 60 minutes
rtegative
autoimmune
free
hemolytic
antiglobulin
64
32
32
64
32
-
the
1)
( 1,000
nucleated
of bone
present
antiglobulin
reaction
artd
with
the antiglobulin
reactions
with
cells
marrow
a patient
reactions
absorbed
in
a
erythro-
are specific
antiglobulin
serum.
The
antiglobulin
tosis
fetalis
cytes
was
with
absorbed
reaction
gave
of reticulocytes
a 3 + reaction
considered
specific
anti-human
(fig.
on
In
previous
procedures
antigens
eran,
studies,
normoblasts
with
of the
Kell,
Lewis,
we
specific
Duffy,
the
patient
antiglobulin
of
negative
with
erythroblas-
reaction
of reticulo-
agglutination
reaction
globulin.
AND
described
including
following
of
The
grounds
DISCUSSION
human
2).
the
the
Kidd
presence
of A,
B and
By
standard
pronormoblasts.”2
antisera,
blood
CoNc1usIoNS
it has
systems
and
been
possible
on
normoblasts:
I. Under
the
H antigens
to demonstrate
experimental
Rh,
on
agglutination
MNSs,
the
P,
conditions
isoLuthde-
From www.bloodjournal.org by guest on June 15, 2017. For personal use only.
BED
CELL
Table
ANTIGENS
OF
2.-Differential
and White
Cells
HUMAN
527
NOBMOBLASTS
Counts
of Free
and Agglutinated
Normoblasts,
Marrow
Obtained
from
(1) a Patient
Autoimmune
Hemolytic
Anemia
and
(2) a Patient
with
Erythroblastosis
Fetalis
Tested
by the Direct
Antiglobulin
Method
Erythrocytes
with
of Bone
Autoimmune
Hemolytic
Anemia
Erythroblastosis
Fetalis
Absorbed
Differential
Counta
(cells/100
nucleated
cells)
% Agglutinated
Erythrocytes
Normoblasts
cells
White
% Free
cells
scribed
red cells
percentage
leaving
of
white
the
exception
agglutinates
were
The
cell
human
antiglobulin
103 (approx.)
95
0
0
0
0
4
0
5
0
Normoblasts
26
18
14
13
30
28
White
93
82
87
72
cells
the treatment
of nucleated
cell
antisera
produced
agglutination
most
cells
of the other
was
usually
preparations
of
were
Tja.a
related
demonstration
reports,4’5
(approx.)
Human
antiglobulin
10
7
free
white
with
vious
cells
paper,
specific
pure
human
antiglobulin
128
96
Erythrocytes
in this
with
marrows
Human
antiglobulin
Absorbed
found
is possible
isoantigens
suggests
that
be
of the
the
bone
marrow.
agglutinates,
lacking
the
in
white
all
antigens
cells
present
bone
and
A small
although
tested
in
the
trapping.”
on
the
to
in
that
to “mechanical
of
and
It
elements
found
suspension
of the
of normoblasts
normoblasts
appearance
is in
of cell
keeping
antigens
with
occurs
preearly
4
I
c
Fig. 1.-Direct
antiglobulin
erythrocytes
of a patient
with
scopy.
X 500. Print
=
2000 X.
positive
autoimmune
agglutination
hemolytic
reaction
anemia.
/
of normoblasts
Phase
contrast
and
micro-
From www.bloodjournal.org by guest on June 15, 2017. For personal use only.
528
YUNIS
Fig. 2.-Direct
erythrocytes
from
antiglobulin
a patient
Wright
stain. X 500. Print
in cell
formation
isoantigens
and
were
positive
agglutination
erythroblastosis
with
2000
=
AND
YUNIS
reaction
of reticulocytes
fetalis.
Brilliant
cresvl
blue
and
and
X.
independent
demonstrated
by
of the
maturation
both
agglutinating
of the
cell.
and
Many
of the
non-agglutinating
antibodies.
Severe
nized
reticulocytopenia,
to
be
molytic
an
anemia.
anemia
globulin
this
been
that
with
anemia
a severe
In
to
numerous
stressed
that
the
the
the
in severe
not
of
transfusion
It
has
able
anemia
bone
failure
to
demonstrate
infants
with
the
of
erythrocyte
of the
Some
variation
fetalis
investigators
in
newborn.8’9
in
the
the
It
anemia”)
on
investigators
normoblastic
from
is
may
effect
Other
suffering
by
sufficiently
suppressive
agglutinins.
and
coated
production
the
direct
be
were
(“aregenerative
a significant
erythroblastosis
of
in
hyperplasia,
to
coated.
disease
offending
reported
hyperplasia
reticulocytes
be
antifrom
autoimmune
shown
to
hypoplasia
cases
of normoblastic
were
hemolytic
as a result
by
two
normoblastic
where
of the
of
lack
normoblasts
shown
marrow
centers
he-
hemolytic
complicating
with
also
erythroblastosis
erythropoietic
were
tivity
and
fetalis
were
The
crises
erythroblastosis,
they
recog-
autoimmune
autoimmune
anemia.4
“aplastic”
the
importance
of
thought
acute
cases,
the
study,
the
pathogenesis
occur
In
is now
of
complicating
reticulocytopenia
both
“aplasia”
others.#{176}Some
workers
have
found
by the
erythrocytes
can be coated
by antibodies
of erythroblastosis
globulin.
have
the
with
case
reticulocytosis.
gamma
by
marrow
complication
crises
hemolytic
illustrate
hemolytic
and
reported
nucleated
of bone
important
“aplastic”
autoimmune
article
result
but
Acute
have
test
patients
the
uncommon
ac-
post-exchange
anemia.10
been
“false”
positive
gamma
shown
globulin
that
the
reported
that
antiglobulin
specificity
coating
of
blood
samples
reaction12’13
rich
which
of the
antihuman
reticulocytes
and
in
do
reticulocytes
not
globulin
normoblasts
depend
serum.14
in the
may
on
give
the
anti-
We
two
have
cases
a
From www.bloodjournal.org by guest on June 15, 2017. For personal use only.
BED
ANTIGENS
CELL
reported
is specific
globulin
conclusion,
anemia
support
marrow
may
the
grounds
the
of negative
findings
the
concept
occur
as
cell
reticulocytopenia.
coating
marrow
results
can
is rare
in
coat
from
with
the
depend
of the
antibody,
offending
with
the
the
absorbed
antihuman
to produce
red
the
and
cells.
on
marrow
and
depression
and
properties
reticulocytes
process
these
bone
anti-
fetalis
physicochemical
hemolytic
Studies
globulin
erythroblastosis
the
bone
explain-
from
the
anti-Rho
that
Bone
in
the
of gamma
normoblasts
sugests
of normoblasts
of the
hemolytic
of
production,
finding
and
fetalis
including
effect
cell
in vivo.
anemia
severity
autoimmune
hypoplasia
hand,
blood
erythrocytes
damaging
with
exceeds
other
factors,
the
in our
patient
normoblastic
peripheral
erythroblastosis
multiple
antibodies,
at present
a
hemolytic
on
individual
the
immature
autoimmune
might
in
that
destruction
On
reticulocytes
of the infant
1)odies
the
on
529
NOBMOBLASTS
HUMAN
serum.
In
ing
OF
and
by
the
questions
are
antigens
of
the
ability
of
in progress
laboratory.
SUMMARY
Evidence
group
of
is
systems
presented
for
on normoblasts.
normoblasts.
The
reticulocytes
and
the normoblasts
iti relationship
in
the
vivo
the
presence
The
antigen
demonstration
normoblasts
of a patient
with
to the pathogenesis
presentate
autoimmune
of the
plure
constatationes
systemas
antigenic
\,i\,O
de
tin
de
gruppos
de
patiente
con
in le duo
gamma
blood
ort all stages
globulin
coating
the
fetalis
and
erythroblastosis
discussed
INTERLINGUA
del
in
presentia
le
e le
es descutite
de
antigenos
normoblastos.
del normoblastos.
le reticulocytos
fetal
hemolytic
nine
detected
hemolytic
anemia
are
anemia
in both
conditions.
sanguine
erythroblastosis
anemia
are
with
evidentia
es detegite
in omne
stadios
globulina
gamma
“revestiente”
autoimmun
anemia
IN
in
the
of
of a patient
SUMMARIO
Es
of
receptors
Le
de
receptores
Le demonstration
e le normoblastos
normoblastos
de
in relation
con
un
in
de
patiente
con
le pathogenese
del
of
and
conditiones.
ACKNOWLEDGMENTS
The
Miss
for
authors
Kathryn
their
from
the
thank
Crave
and
wish
to
Anne
constant
War
and
Dr.
Dorothy
Miss
invaluable
Memorial
Ella
help
Blood
Bank,
Sundberg
Spanjers
in providing
kindly
for
from
supplied
her
the
review
Special
marrow
some
samples.
of
the
manuscript
Hematology
the
Laboratory
Mrs.
antisera
Jane
Swanson
used.
REFERENCES
1. Ynnis,
2.
-,
J. J.,
and
E.:
Cell
anti-
Examination
gens
and
cell
specialization.
I.
A
study of blood
group
antigens
on norinoblasts.
Blood
22:53,
1983.
and -:
Cell antigens
and
cell specialization.
IV.
normoblasts,
3.
Yunis,
platelets.
Curner,
B.
On
tile
H
substance
and
megakaryocytes
Blood
W.,
24:531,
and
Coombs,
of
1984.
R.
R. A.:
tile
Lewis
of mixed
tination.
4.
of
ABO,
Pisciotta,
currence
MN,
systems
human
Rh,
Tj,
of
antigens
leucocytes
erythrocyte-leucocyte
Vox Sang.
3:13,
V.,
A.
of
blasts.
Proc.
358,
1958.
and
Hinz,
agglutinins
Soc.
for
Lutheran
by
means
agglu-
1958.
J.
in
Exper.
and
E.:
Oc-
nornio-
Biol.
91:
From www.bloodjournal.org by guest on June 15, 2017. For personal use only.
530
5.
YUNIS
Rossi, V., and Diena,
F.:
of the erythroblastic
activi-
Damage
by
ties
pean
Soc. of Haemat.
2:701,
1957.
6. Davis,
L. J., Kennedy,
A. C., Baikie,
C.,
and
anaemias
ACTH
Brown,
A.:
of various
types
and
cortisone.
Steffen,
C.:
A.
11.
bei
hamolystischer
15,
1955.
H.
study
J.
C.
67:224,
H.:
generative
Chronic
immunization
12.
by
congenital
associated
with
blood
group
I. Yunis,
M.D.,
cal Genetics
University
of
Minnesota,
Singer,
iso-
cytic
Clin.
14.
The
Pediatrics
Blood
of
J. Yunis,
Bank,
M.D.,
Department
Minnesota,
School
Associate
of Laboratory
of Medicine,
23:
and
red
55:663,
Motuisky,
A.
(Coombs)
False
test
Sang.
and
6:348,
Director
Medicine,
C.:
test
Professor
and
J.
Lab.
antihuman
by
reticulocytes.
1961.
of MediMedicine,
Director
University
Minn.
The
sphero-
Minneapolis,
Medicine,
Minneapolis,
J.
in
positive
caused
se-
cells.
1960.
MEnu.
Edmond
Serial
hemolytic
agglutination
and
of Laboratory
of
16:
W.:
in
immature
Med.
D.:
Vox
School
Krivit,
newborn.
of
globulin
Professor
of
Pcdiatrics
hemolytic
anemias.
Med. 34:768,
1949.
Nelken,
Department
Obserphase
marrow
the
H.:
K.,
are-
A.
Assistant
Laboratory,
and
& Clin.
developing
Blood
4:697,
1949.
9. Cibblett,
E. R., Varela,
J. E., and Finch,
C. A.: Damage
of the bone
marrow
Jorge
J.
Lab.
13.
P.:
1959.
Jandl,
klin
Sturgeon,
fetalis.
questration
1955.
anemia
17:37,
convalescent
bone
of
314,
an
Wien
Pediatrics
and
the
C.,
of
disease
erworkemer
an#{228}mie.
Wchnschr.
B.,
on
Dillon,
with
antikorper
Knockenmarkzellen
antibody.
erythroblastosis
#{252}ber den
sessiler
C.
vations
M.
Untersuchungen
nachroeis
Smith,
Clasgow
Hyman,
1952.
33:263,
8.
10.
Haemolytic
treated
to Rh
YUNIS
1956.
sera
of acquired
hemolytic
Trans.
6th
Congress
Euro-
anemia.
7.
due
C.,
Sacchetti,
AND
of
&
From www.bloodjournal.org by guest on June 15, 2017. For personal use only.
1964 24: 522-530
Cell Antigens and Cell Specialization. II. Demonstration of Some Red Cell
Antigens of Human Normoblasts
JORGE J. YUNIS and EDMOND J. YUNIS
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