168 MONOCLONAL ANTIBODIES FOR THE EARLY DETECTION OF ERYTHROCYTE MEMBRANE DEFECTS IN FATAL HEMOLYTIC ANEMIA AND HEMOLYTIC UREMIC SYNDROM |[lpar]|HUS|[rpar]|

摘要

For the early detection of membrane desialization due to the in vivo action of microbial neuraminidases with a high risk for fatal hemolytic anemia or hemolytic uremic syndrome 4 monoclonal antibodies were generated. They are recognizing different epitopes of the main surface glycoprotein of human red cells after treatment with bacterial toxin, as determined by immunoblotting of erythrocyte ghost proteins and an analysis of asialoglycophorin A binding in a liquid phase radioimmunoassay. Using these mcab, the red cells of 113 children were investigated, who suffered from parainfectious hemolytic anemia or aquired membrane abnormalities associated with erythrocyte polyagglutinability. The reactivity of the mcab in hemagglutination tests and fluorescent staining of target erythrocytes was restricted to 3 cases of neuraminidase induced HUS. In these patients immediate initiation of adequate treatment (hemodialysis, exchange transfusion for toxin elimination and substitution of neuraminidase inhibitor, antibiotic therapy) could prevent the fatal course of the disease, normally causing its high mortality rate.