The presence of polyagglutinable red blood cells may have a variety of implications for the patient.
Features of polyagglutinable red blood cells:
(1) RBC agglutination occurs on exposure to serum from most adults (in the implementation this will stipulate adults of the same ABO type)
(2) failure of RBC agglutination by serum from
(2a) infants
(2b) the patient
(2c) a patient with the same type of polyagglutination
The presence of polyagglutination may go unrecognized if monoclonal or oligoclonal antisera is used in testing. These lack the IgM antibodies usually associated with the polyagglutination.
Type
Antigen
Features
acquired and transient
T, Tk, Th, Tx
associated with a bacterial infection. Bacterial enzymes modify surface of the red blood cells to expose hidden antigens
acquired and persistent
Tn
associated with an abnormal clone of red blood cells. This may be an indication of myelodysplasia, in which case there is a risk for progression to acute leukemia.
lifelong and inherited
Cad, NOR or HEMPAS
inheritance of a polyagglutinable antigen
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