Neutrophil Antibody Screen

Neutrophil Antibodies are antibodies produced by human body in order to fight foreign White Blood Cells (WBCs). Neutrophil Antibodies attack all types of White Blood Cells and their engagement is not limited Neutrophils only. Neutrophil Antibodies are given this name since the majority of White Blood Cells are Neutrophils and to avoid any misunderstand of using the term “WBC Antibodies” which would mean the antibodies found normally on the surface of White Blood Cells.

 

Where would foreign White Blood Cells come from? You may ask yourself. They come from blood transfusion procedures. Human immune system considers White Blood Cells that have incompatible Human Lymphocyte as foreign microorganisms and it starts producing Neutrophil Antibodies to protect the body from those foreign WBCs.

 

It is possible to prevent incompatible White Blood Cells from being introduced to the body by making a complete hitocompatibility testing before organ or tissue implant procedures. When it comes to blood transfusion however, these procedures usually take place in high emergency conditions that are accompanied with excessive bleeding. The risk of such conditions makes blood transfusion a pressing and time sensitive decision to make since the doctor’s highest priority is to save the patient’s life than running thorough compatibility testing to prevent possible blood transfusion reactions that may occur afterwards.

 

Also blood transfusion procedures have been widely and almost all physicians were familiar with them and with post-transfusion reactions for many years before histocompatibility testings are being used by a limited number of surgeons who are specialized in organ transplant. This wide use and common familiarity of blood transfusion versus the limited use of histocompatibility testings to didn’t give a chance for histocompatibility testings to be considered before a blood transfusion is ordered.

 

 

 

Symptoms of Blood Transfusion Reactions

Human body starts developing Neutropphil Antibodies during blood transfusions if incompatible White Blood Cells are found in the donor’s blood. As a result, patients may experience a blood transfusion reaction if complete compatibility testing wasn’t performed before blood administration.

 

Patients who suffer from blood transfusion reactions can show symptoms of the reaction either during or after the transfusion procedure is completed. These symptoms usually include:

  • Fever.
  • Chills.
  • Rash.
  • Back Pain.
  • Blood in Urine.
  • Fainting,.
  • Dizziness.

 

 

 

Non-Immunologic Post-Transfusion Reactions

Symptoms of Reactions to blood transfusion can also occur due insufficient efficiency of the donated blood, infection, or contamination with bacteria. Bacterial contamination of blood usually occurs when the blood is stored for long periods of times.

 

While the donor’s blood is being tested for possible viral infections, rare infection possibilities still exist. For example the possibility of Hepatitis C infection after blood transfusion is one out of two millions and for HIV infections the possibility is one out of 3 millions. Non-Immunologic blood transfusion reactions also include:

 

 

  • Bacterial.
  • Fluid overload.
  • Hypothermia.
  • Human T-Lymphotropic Virus (HTLV).
  • Iron and Electrolyte Overload.
  • Hepatitis B.
  • Coagulation and Immune Dilution.
  • Cytomegalovirus.
  • Syphilis.
  • Chagas Disease.

 

 

When a patient shows symptoms of post-transfusion reaction, it is very important to determine if the reaction is caused by an infection or if it is an immunologic response to the antibodies found in the donor’s and receptor’s blood. To determine if source of the reaction is immune mediated, a Neutrophil Antibody Screen is ordered along with other antibody screening tests to confirm if the reaction is immune mediated.

 

 

 

 

Immunologic Post-Transfusion Reactions

The Immunologic Reaction to blood transfusion ranges from simple fever to sever injuries. The most common reaction the having fever during and after the transfusion procedure when the recipient’s Neutrophil Antibodies start attacking the donor’s incompatible White Blood Cells. Since white blood cells are found in very low amounts in human body, this reaction doesn’t affect the patient for long time.

 

Severe reactions occur when the donor’s blood contains antibodies to the recipient’s White Blood Cells. In this case, a higher number of white blood cells is being attacked, and these White Cells are actually the patient’s own White Blood Cells. This type of reactions may cause severe transfusion reactions, including Multiorgan System Failure, and acute pulmonary failure (a condition known as Transfusion-Related Acute Lung Injury [TRALI]).  Most of the transfusion related mortality are actually caused by the occurrence of Transfusion-Related Acute Lung Injury. In TRALI occurs, Human Lymphocyte Antigens (HLAs) or Neutrophil Antibodies of the recipient are found in the donor’s blood which indicates that TRALI may occur because of transferring those antibodies from the recipient blood to the donor blood during transfusion.

 

Immunologic reactions to blood transfusion include:

  • Delayed Serologic Reaction.
  •  Acute Hemolytic Reaction.
  • Febrile Nonhemolytic Reaction.
  • Allergic Reaction.
  • Anaphylactic Allergic Reaction.
  • Acute Lung Injury.
  • Post-transfusion Purpura.

 

Neutrophil Antibodies can also be generated due to recent blood transfusion prior to the current transfusion. Also recent administration of Dextran or IV contrast agents are found to cause the body to generate Neutrophil Antibodies.

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