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Flow cytometric quantitation of serum anti-D in pregnancy

Authors

  • M. Christensson,

    Corresponding author
      1 Marta S. Christensson, MD, Senior Physician, Division of Clinical Immunology, Department of Immunology, Microbiology, Pathology and Infectious Diseases, Karolinska Institute, F79, Huddinge Hospital, S-14186 Huddinge, Sweden.
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  • K. Bremme,

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    • 2

      Katarina Bremme, MD, Associate Professor, Department of Obstetrics and Gynecology, Karolinska Hospital, Stockholm, Sweden.

  • A. Shanwell,

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    • 3

      Agneta Shanwell, MD, PhD, Senior Physician, Stockholm Blood Transfusion Service, Huddinge University Hospital.

  • M. Westgren,

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    • 4

      Magnus Westgren, MD, Associate Professor, Department of Obstetrics and Gynecology, Karolinska Institute, Huddinge University Hospital.

  • B. Christensson

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    • 5

      Birger Christensson, MD, Associate Professor, Department of Obstetrics and Gynecology, Karolinska Institute, Huddinge University Hospital.


1 Marta S. Christensson, MD, Senior Physician, Division of Clinical Immunology, Department of Immunology, Microbiology, Pathology and Infectious Diseases, Karolinska Institute, F79, Huddinge Hospital, S-14186 Huddinge, Sweden.

Abstract

BACKGROUND: The major cause of fetal hemolytic disease is maternal immunization to D in D-incompatible pregnancies. To prevent complications, D-incompatible pregnancies are monitored for the level of maternal anti-D. At present, the monitoring of anti-D levels is performed by the indirect antiglobulin test complemented by quantitation by the technique used in an automated antibody detection and quantitation instrument. STUDY DESIGN AND METHODS: Flow cytometry was used to quantitatively determine the level of anti-D in serum and to analyze the IgG subclass distribution and the presence of IgM anti-D in these samples. The results were compared to the indirect antiglobulin test titer and to the results obtained by the technique used in an automated antibody detection and quantitation instrument. RESULTS: Flow cytometry allowed sensitive and accurate determinations of anti-D levels with low interassay and intra-assay variability, both for serum samples and standard curves. CONCLUSION: Flow cytometry is a simple, rapid, and reliable method for determining the serum levels of D antibodies and their Ig subclass distribution. It is therefore well suited for the monitoring of women during D-incompatible pregnancies.

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