Transfusion in the Face of Autoantibodies

It is not unusual for patients to have antibodies directed against their own red blood (RBCs).In many cases, these autoantibodies are totally benign and cause no clinical problems. However, in some instances autoantibodies can cause hemolysis in the patient. If this hemolysis is substantial, an autimmune hemolytic anemia will develop with significant clinical signs and symptoms. Autoantibodies are readily detected in th Blood Bank laboratory, regardless of whether the autoantibody is pathogenic or benign. This can make it piossible to find compatible blood. In this chapter, the differences between benign and clinically significant autoantibodies are discussed. Next, we discuss the pathophysiology, clinical presentation, laboratory test results, and transfusion therapy for autoimmune hemolytic anemias. Finally, we discuss other situations in which potentially clinically significant autoantibodies can arise.