Dia와 Mia 항원을 포함한 적혈구 특이 항원에 대한 비예기항체 빈도 및그 특성에 관한 연구 = Prevalence and Specificity of Unexpected Antibody Using Antibody Screening Test Including Dia and Mia Cells

국문 초록 (Abstract)

배경 : 현재까지 국내에서 보고된 비예기항체의 빈도와 분포에관한 연구는 상품화된 코카시안의 적혈구 판넬을 이용한 연구로한국인과 동남아시아인에서 높은 항원 빈도를 보이는 Dia과 M ia이 포함되지 않았다. 본 연구는 이 두가지 적혈구 항원을 포함한항체선별검사를 실시한 후 이들 항원에 대한 비예기항체의 빈도,항체의 특성 및 그 임상적 중요성을 분석하고자 시행되었다.방법 : 비예기항체의 빈도와 분포를 알아보기 위해 2001년 3월부터 2003년 9월까지 17,664예를대상으로 Dia 항원을 포함한 비예기항체 선별검사를(ID-DiaCell I+II and ID-DiaCell Dia+ Dia-Med AG, Cressier, Morat, Switzerland)시행하였고, 2003년 4월부터는 Mia 항원을(ID-DiaCell I+II+III Asia; DiaMed AG)추가하여 검사하였다. 비예기항체의 선별검사와 동정은 LISS/Coombs card (DiaMed AG)를 사용하였다.결과 : 비예기항체의 빈도는 1.2% (214/17664)이었다. 항체동정이 시행된 159명 중 Rh계열이 46.5%, Lewis계열이 13.2%,항-Dia 항체는 9.4%이었다. 항-Mia 항체는 3명의 환자에서 동정되었다. 항-Dia 항체와 항-Mia는 IgG 특이성을 보였고 항-Dia 항체는 모두 면역항체였고 항-Mia는 면역항체와 자연항체가 혼재되어 있었다.
결론 : 항-Dia와 항-Mia 항체가 한국인에서 빈번히 존재하므로 안전한 수혈을 위해서는 Dia와 Mia 항원을 포함한 비예기항체 선
별검사가 필요한 것으로 생각된다.

다국어 초록 (Multilingual Abstract)

Background : The purpose of this study was to examine the prevalence and distribution of unexpected antibodies detected in the Korean population with race-specific RBC panel cells. In spite of a relatively high prevalence of Dia and Mia antigen phenotype in the Korean and Southeast Asian population, there has been little documented research on the prevalence and clinical significance of anti-Dia and anti-Mia in Korea. Methods : We analyzed the results of 17,664 antibody screening tests performed during the recent 30-month period from March 2001 to September 2003. Antibodies were screened and identified by
using LISS/Coombs gel card with DiaMed-ID system (DiaMed AG, Cressier, Morat, Switzerland) including Dia and Mia panel cells. Results : The prevalence of unexpected antibodies was 1.2% (214/17,664); antibodies detected most frequently were anti-Rh (74 patients), followed by anti-Lewis (21 patients) and anti-Dia (15 patients). Out of 6,345 patients, anti-Mia was detected in three patients (0.047%). Anti-Dia and anti-Mia had the specificity of IgG. Anti-Dia was thought as an immune-mediated antibody, whereas anti-Mia was considered as a mixed type with immune and natural antibodies. Conclusions : This study shows that anti-Dia and anti-Mia antibodies are detected frequently in the Korean population; hence, it seems that Dia and Mia panel cells should be incorporated into antibody screening panels in Korea for safe transfusion

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