03233nas a2200337   4500008004100000020001400041024001700055245020400072210006900276260029900345300001400644490000700658520181100665653001202476653001102488653002502499653007202524653002602596653003002622653002902652653003102681653001402712100001902726700001702745700001902762700001802781700001702799700001902816700001502835856004502850       2015                        eng d  a0041-1132  awdn, 041736000aA hemolytic anti-LKE associated with a rare LKE-negative, "weak P" red blood cell phenotype: alloanti-LKE and alloanti-P recognize galactosylgloboside and monosialogalactosylgloboside (LKE) antigens.0 ahemolytic antiLKE associated with a rare LKEnegative weak P red   a(C) 2015 John Wiley & Sons, Ltdb(1) Department of Pathology, University of Michigan, Ann Arbor, Michigan,(2) Department of Nephrology, University of Michigan, Ann Arbor, Michigan,(3) American Red Cross Blood Services, Southern Region, Atlanta, Georgia,(4) Veteran's Administration Hospitc2015  a115 - 1280 v553 a<p>BACKGROUND: &quot;Weak P&quot; is a rare red blood cell (RBC) phenotype, characterized by a global decrease in Pk and P antigens. We now describe a second weak P individual who also typed LKE-negative (LKE-N) and possessed a clinically significant anti-LKE., STUDY DESIGN AND METHODS: Patient RBCs and plasma were examined by standard serology and flow cytometry. Glycosphingolipids (GSLs) from patient, Pk, and LKE-strong (LKE-S) RBCs were isolated and analyzed by high-performance thin-layer chromatography (HPTLC). To confirm antibody specificity, patient serum and 30 human polyclonal controls, including alloanti-P and anti-PP1Pk, were tested against a panel of GSLs by HPTLC immunostaining., RESULTS: The patient typed P1+, P+, and LKE-N and possessed a &quot;P-like&quot; panagglutinin. In a two-stage indirect antiglobulin test, the patient&#39;s plasma caused hemolysis of LKE-S cells but not p, Pk, or LKE-N cells. Clinically, transfusion of P+ RBCs compatible by a prewarmed technique had shortened RBC survival with laboratory evidence of hemolysis. Analysis of the patient&#39;s isolated RBC GSLs showed a 30% relative decrease in Gb3 (Pk) and Gb4 (P) and a 90% decrease in monosialogalactosylgloboside (MSGG, LKE), accompanied by increased lactosylceramide (CDH), paragloboside, and GM3. On HPTLC immunostaining, the patient&#39;s plasma strongly bound MSSG with weak binding to galactosylgloboside (Gb5). Binding to MSGG, Gb5, and Gb4 was also observed with some examples of alloanti-P from Pk individuals, but not anti-PP1Pk, autoanti-P, or normal controls., CONCLUSIONS: We describe the first example of a clinically significant anti-LKE in the setting of a rare weak P background. Human alloanti-LKE and some alloanti-P recognized Gb5 and MSGG., (C) 2015 John Wiley &amp; Sons, Ltd</p>10a*Anemia10aAnemia10aAntibody Specificity10aAntineoplastic Combined Chemotherapy Protocols/tu [Therapeutic Use]10aAutoimmune/bl [Blood]10aAutoimmune/di [Diagnosis]10aAutoimmune/ge [Genetics]10aAutoimmune/im [Immunology]10aHemolytic1 aCooling, Laura1 aDake, Louann1 aHaverty, Donna1 aMullis, Nancy1 aEllis, Susie1 aShayman, James1 aJudd, John  uhttps://notifylibrary.org/reference/4134