Mechanisms: Some patients in the pool may have high titers of ABO antibodies.
Some manufacturers remove these antibodies by affinity chromatography during product preparation.
Patient subject to hemolysis: ABO types A, B or AB
Manifestations:
(1) unexplained fall in hemoglobin
(2) pink serum after infusion
(3) jaundice or hyperbilirubinemia
(4) fall in serum haptoglobin
(5) positive antiglobulin test
The diagnosis can be confirmed by reacting the immune globulin preparation against reagent A or B cells. Since the potential antibody may be IgG a direct antiglobulin test (DAT) step should be included.
Differential diagnosis:
(1) warm or cold autoimmune hemolytic disease
(2) vasculitis associated with the underlying disease
