Isoantibodies in Immunoglobulin for Intravenous Use May Cause Erythrocyte Sequestration

Background and Objectives: IVIg, while generally a safe therapy for a variety of immunological disorders, can have detrimental effects on erythrocyte (RBC) homeostasis. We studied the mediation of erythrophagocytosis by isoantibodies in IVIg. Materials and Methods: RBC were exposed to IVIg and bindi...

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Bibliographic Details
Published in:Vox sanguinis 1999-08, Vol.77 (1), p.33-39
Main Authors: Shoham-Kessary, H., Gershon, H.
Format: Article
Language:English
Subjects:
Immunohaematology
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Summary:Background and Objectives: IVIg, while generally a safe therapy for a variety of immunological disorders, can have detrimental effects on erythrocyte (RBC) homeostasis. We studied the mediation of erythrophagocytosis by isoantibodies in IVIg. Materials and Methods: RBC were exposed to IVIg and binding of IgG determined by flow cytometry. In vitro phagocytosis of these RBC was assayed. Results: Anti–A and anti–B in IVIg mediate Fc–dependent erythrophagocytosis even in the presence of excess IVIg. Removal of these isoantibodies from IVIg prevents IgG binding and erythrophagocytosis. Complement enhances IVIg–mediated RBC sequestration. Conclusion: It may be desirable to remove isoantibodies from IVIg especially for anemic patients or those who respond to the IVIg with a hemolytic episode.
ISSN:0042-9007
1423-0410
DOI:10.1159/000031071