혈소판 동종면역이 Platelet Associated IgG ( PAIgG ) 에 미치는 영향에 관한 연구 = Effects of Alloimmunization on Platelet Associated Immunogloblin G ( PAIgG )

다국어 초록 (Multilingual Abstract)

To assess the development of refractoriness and/or alloimmunization and the changes of platelet-associated IgG (PAIgG) in patients with a history of blood transfusions, platelet increments and platelet recovery were determined after platelet transfusions from random donors, and PAIgG in the sera and on the surface of the platelets were measured by an ELISA method in 17 thrombocytopenic patients with the following results. 1) Six out of 10 patients (60.0%) with a history of multiple transfusions showed refractoriness to transfusion of random donors' platelet. Some of these patients, however, responded to platelet transfusions from a few donors, and some patients who belonged to the non-multitransfused group were refractory to random donor platelets. 2) In the refractory group with a history of multiple transfusions, one-hour-and 24-hour-platelet increments were decreased in 11 out of 15 (73.3%) and in 13 out of 14 (92.9%) transfusions respectively, while the one-hour- and 24-hour platelet recovery were depressed in 11 out of 15 (73.3%) and all the 14 transfusions (100%), respectively. 3) PAlgG on the surface of the platelets were increased in 5 out of 6 (83.3%) patients who belonged to the refractory group with a history of multiple transfusions. PAIgG levels were within normal limits in all the three (100%) patients who responded to platelet transfusions. In the non-multitransfused group, however, PAIgG levels were increased in 2 out of 6(33.3%) patients. 4) Out of the six patients who were refractory to random donor platelets, an increase of serum PAIgG values was observed in 4 (66,7%) and in 4 (66.7%) respectively when tested with two different type 0 donor platelets. All the patients showed an increased value of serum PAIgG when tested with one or another donor platelets, 5) Serum PAIgG values determined with an indirect method revealed a significant variation in distribution when mearsured with different donor platelets. They showed, however, a tendency to be distributed in a certain range in each test made with different donor platelets in normal controls and in the throm-bocytopenic patients, as well. 6) The mixed platelet suspension was found to have an effect to neutralize the variance of the distribution of serum PAIgG values determined with different donor platelets. From the above observations, it could be concluded that PAIgG values on the surface of the platelets and in sera were a good index for the diagnosis of alloimmun-ization in multitransfused patients.