Fenotipagem e aloimunização eritrocitária em portadores de anemia falciforme atendidos no Hemocentro de Alagoas
Autor(a) principal: | |
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Data de Publicação: | 2010 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Repositório Institucional da UNIFESP |
dARK ID: | ark:/48912/0013000017xd3 |
Texto Completo: | http://repositorio.unifesp.br/handle/11600/9650 |
Resumo: | Objective: To determine the erythrocyte phenotyping in blood donors and patients with sickle cell anemia (SS) assisted at Hemocentro of Alagoas and also the frequency and factors associated with erythrocyte alloimmunization. Methods: Cross-sectional study with 102 patients with sickle cell anemia (SS) and 100 blood donors. This study was approved by the Ethical Committee of the Federal University of São Paulo and by the Ethical Committee of the University of Science of Health of Alagoas. Patients and blood donors were requested to sign an informed consent form prior to enrolment. The following tests were performed: erythrocyte phenotyping by gel centrifugation, Direct antiglobulin test, Indirect antiglobulin test, and detection of irregular antibodies by panels of phenotyped red blood cells. Variables were compared by Mann-Whitney test and c 2 test or exact Fisher test. Factors associate with alloimmunization was analyzed by univariate and multiple logistic regression analysis. Differences were considered significant if p<0.002. Results: The most frequent antigens found in patients and blood donors were: c (93.1% vs. 83.0%), and (96.1% vs. 94.0%), M (82.4% vs. 82.0%), s (92.2% vs. 79.0%), JK(a) (88.2% vs. 82.0), respectively. Significant differences were observed between the frequency of the phenotype of patients and donors in regard to antigens s, FY(a) and JK(b). From 79 transfused patients, 10 (12.7%) presented positive Indirect Coombs. Thirteen alloantibodies were found, 7 from Rh system, 2 from Kell and 4 were not identified. Factors associated with alloimmunization were the period of time between the last transfusion and the data of the test and being submitted to more than 10 red blood cell transfusions. Patients who received more than 10 transfusions presented a likelihood of presenting alloimmunization 16.39 (2.23-120.59) times higher than who received less than 10 transfusions. All patients presented a negative Direct antiglobulin test. Conclusion: The prevalence of alloimmunization in patients with sickle cell anemia was 12.7% with 70% of antibodies belonging to Rh and Kell systems. This study shows the importance of performing erythrocyte phenotyping in blood donors and receptors in order to decrease the risk of alloimmunization. |
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Fenotipagem e aloimunização eritrocitária em portadores de anemia falciforme atendidos no Hemocentro de AlagoasErythrocyte phenotyping and alloimmunization in patients with sickle cell anemia assisted at HEMOAL from AlagoasAlloantibodiesAlloimmunizationAntigensErythrocyte transfusionAnemia, sickle cellIsoantibodiesAloimunização. AloanticorpoAntígenosTransfusão de hemáciasAnemia falciformeTransfusão de eritrócitosIsoanticorposAloanticorpoObjective: To determine the erythrocyte phenotyping in blood donors and patients with sickle cell anemia (SS) assisted at Hemocentro of Alagoas and also the frequency and factors associated with erythrocyte alloimmunization. Methods: Cross-sectional study with 102 patients with sickle cell anemia (SS) and 100 blood donors. This study was approved by the Ethical Committee of the Federal University of São Paulo and by the Ethical Committee of the University of Science of Health of Alagoas. Patients and blood donors were requested to sign an informed consent form prior to enrolment. The following tests were performed: erythrocyte phenotyping by gel centrifugation, Direct antiglobulin test, Indirect antiglobulin test, and detection of irregular antibodies by panels of phenotyped red blood cells. Variables were compared by Mann-Whitney test and c 2 test or exact Fisher test. Factors associate with alloimmunization was analyzed by univariate and multiple logistic regression analysis. Differences were considered significant if p<0.002. Results: The most frequent antigens found in patients and blood donors were: c (93.1% vs. 83.0%), and (96.1% vs. 94.0%), M (82.4% vs. 82.0%), s (92.2% vs. 79.0%), JK(a) (88.2% vs. 82.0), respectively. Significant differences were observed between the frequency of the phenotype of patients and donors in regard to antigens s, FY(a) and JK(b). From 79 transfused patients, 10 (12.7%) presented positive Indirect Coombs. Thirteen alloantibodies were found, 7 from Rh system, 2 from Kell and 4 were not identified. Factors associated with alloimmunization were the period of time between the last transfusion and the data of the test and being submitted to more than 10 red blood cell transfusions. Patients who received more than 10 transfusions presented a likelihood of presenting alloimmunization 16.39 (2.23-120.59) times higher than who received less than 10 transfusions. All patients presented a negative Direct antiglobulin test. Conclusion: The prevalence of alloimmunization in patients with sickle cell anemia was 12.7% with 70% of antibodies belonging to Rh and Kell systems. This study shows the importance of performing erythrocyte phenotyping in blood donors and receptors in order to decrease the risk of alloimmunization.Objetivo: Determinar a imunofenotipagem eritrocitária em doadores de sangue e em pacientes com anemia falciforme (SS) atendidos no Hemocentro de Alagoas, além de descrever a frequência e os fatores associados à aloimunização eritrocitária. Método: Estudo transversal realizado com 102 pacientes com anemia falciforme (SS) e 100 doadores de sangue. Estudo aprovado pelos Comitês de Ética em Pesquisa da Universidade Federal de São Paulo e da Universidade de Ciências da Saúde de Alagoas. Foi solicitada a assinatura do Termo de Consentimento Livre e Esclarecido antes da inclusão no estudo. Realizou-se a fenotipagem eritrocitária pelo método de gel centrifugação, teste de Coombs Direto (CD), Coombs Indireto (CI) e detecção de anticorpos irregulares por painéis de hemácias fenotipadas. Os dados coletados foram comparados por meio do teste de Mann- Whitney e qui-quadrado ou teste exato de Fisher. Para análise dos fatores associados à aloimunização foi utilizada a regressão logística univariada e múltipla. Considerou-se nível de significância estatística p<0,05. Resultados: Os antígenos mais frequentes entre os pacientes e os doadores foram, c (93,1% vs. 83,0%), e (96,1% vs. 94,0%), M (82,4% vs. 82,0%), s (92,2% vs. 79,0%), JK(a) (88,2% vs. 82,0), respectivamente. Observaram-se diferenças estatísticas significantes entre as frequências dos fenótipos dos pacientes e dos doadores em relação aos antígenos s, FY(a) e JK(b). Dos 79 pacientes transfundidos, 10 (12,7%) apresentaram CI positivo. Foram detectados 13 aloanticorpos, sete do sistema Rh, dois do Kell e quatro não foram identificados. Os fatores associados à aloimunização foram o intervalo de tempo entre a última transfusão e a data do exame e ter recebido mais de 10 transfusões de hemácias. O paciente que recebeu mais de 10 transfusões apresentou uma chance 16,39 (IC95%: 2,23- 120,59) vezes maior de ser aloimunizado, comparado àqueles que receberam menos de 10 transfusões. Todos os pacientes apresentaram CD negativo. Conclusão: A prevalência de aloimunização nos pacientes portadores de anemia falciforme foi 12,7%, sendo 70% dos anticorpos encontrados pertencente a grupos sanguíneos Rh e Kell. Esse estudo mostra a importância de realizar a fenotipagem eritrocitária em doadores e receptores para diminuir o risco de aloimunização.TEDEBV UNIFESP: Teses e dissertaçõesUniversidade Federal de São Paulo (UNIFESP)Dos Santos, Amelia Miyashiro [UNIFESP]Universidade Federal de São Paulo (UNIFESP)Pinto, Patrícia Costa Alves [UNIFESP]2015-07-22T20:50:15Z2015-07-22T20:50:15Z2010-11-24info:eu-repo/semantics/masterThesisinfo:eu-repo/semantics/publishedVersion66 p.application/pdfPINTO, Patrícia Costa Alves. Fenotipagem e aloimunização eritrocitária em portadores de anemia falciforme atendidos no Hemocentro de Alagoas. 2010. 66 f. Dissertação (Mestrado em Ciências) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2010.Tese-12392.pdfhttp://repositorio.unifesp.br/handle/11600/9650ark:/48912/0013000017xd3porinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2024-07-30T01:30:27Zoai:repositorio.unifesp.br/:11600/9650Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652024-12-11T21:02:34.939352Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.none.fl_str_mv |
Fenotipagem e aloimunização eritrocitária em portadores de anemia falciforme atendidos no Hemocentro de Alagoas Erythrocyte phenotyping and alloimmunization in patients with sickle cell anemia assisted at HEMOAL from Alagoas |
title |
Fenotipagem e aloimunização eritrocitária em portadores de anemia falciforme atendidos no Hemocentro de Alagoas |
spellingShingle |
Fenotipagem e aloimunização eritrocitária em portadores de anemia falciforme atendidos no Hemocentro de Alagoas Pinto, Patrícia Costa Alves [UNIFESP] Alloantibodies Alloimmunization Antigens Erythrocyte transfusion Anemia, sickle cell Isoantibodies Aloimunização. Aloanticorpo Antígenos Transfusão de hemácias Anemia falciforme Transfusão de eritrócitos Isoanticorpos Aloanticorpo |
title_short |
Fenotipagem e aloimunização eritrocitária em portadores de anemia falciforme atendidos no Hemocentro de Alagoas |
title_full |
Fenotipagem e aloimunização eritrocitária em portadores de anemia falciforme atendidos no Hemocentro de Alagoas |
title_fullStr |
Fenotipagem e aloimunização eritrocitária em portadores de anemia falciforme atendidos no Hemocentro de Alagoas |
title_full_unstemmed |
Fenotipagem e aloimunização eritrocitária em portadores de anemia falciforme atendidos no Hemocentro de Alagoas |
title_sort |
Fenotipagem e aloimunização eritrocitária em portadores de anemia falciforme atendidos no Hemocentro de Alagoas |
author |
Pinto, Patrícia Costa Alves [UNIFESP] |
author_facet |
Pinto, Patrícia Costa Alves [UNIFESP] |
author_role |
author |
dc.contributor.none.fl_str_mv |
Dos Santos, Amelia Miyashiro [UNIFESP] Universidade Federal de São Paulo (UNIFESP) |
dc.contributor.author.fl_str_mv |
Pinto, Patrícia Costa Alves [UNIFESP] |
dc.subject.por.fl_str_mv |
Alloantibodies Alloimmunization Antigens Erythrocyte transfusion Anemia, sickle cell Isoantibodies Aloimunização. Aloanticorpo Antígenos Transfusão de hemácias Anemia falciforme Transfusão de eritrócitos Isoanticorpos Aloanticorpo |
topic |
Alloantibodies Alloimmunization Antigens Erythrocyte transfusion Anemia, sickle cell Isoantibodies Aloimunização. Aloanticorpo Antígenos Transfusão de hemácias Anemia falciforme Transfusão de eritrócitos Isoanticorpos Aloanticorpo |
description |
Objective: To determine the erythrocyte phenotyping in blood donors and patients with sickle cell anemia (SS) assisted at Hemocentro of Alagoas and also the frequency and factors associated with erythrocyte alloimmunization. Methods: Cross-sectional study with 102 patients with sickle cell anemia (SS) and 100 blood donors. This study was approved by the Ethical Committee of the Federal University of São Paulo and by the Ethical Committee of the University of Science of Health of Alagoas. Patients and blood donors were requested to sign an informed consent form prior to enrolment. The following tests were performed: erythrocyte phenotyping by gel centrifugation, Direct antiglobulin test, Indirect antiglobulin test, and detection of irregular antibodies by panels of phenotyped red blood cells. Variables were compared by Mann-Whitney test and c 2 test or exact Fisher test. Factors associate with alloimmunization was analyzed by univariate and multiple logistic regression analysis. Differences were considered significant if p<0.002. Results: The most frequent antigens found in patients and blood donors were: c (93.1% vs. 83.0%), and (96.1% vs. 94.0%), M (82.4% vs. 82.0%), s (92.2% vs. 79.0%), JK(a) (88.2% vs. 82.0), respectively. Significant differences were observed between the frequency of the phenotype of patients and donors in regard to antigens s, FY(a) and JK(b). From 79 transfused patients, 10 (12.7%) presented positive Indirect Coombs. Thirteen alloantibodies were found, 7 from Rh system, 2 from Kell and 4 were not identified. Factors associated with alloimmunization were the period of time between the last transfusion and the data of the test and being submitted to more than 10 red blood cell transfusions. Patients who received more than 10 transfusions presented a likelihood of presenting alloimmunization 16.39 (2.23-120.59) times higher than who received less than 10 transfusions. All patients presented a negative Direct antiglobulin test. Conclusion: The prevalence of alloimmunization in patients with sickle cell anemia was 12.7% with 70% of antibodies belonging to Rh and Kell systems. This study shows the importance of performing erythrocyte phenotyping in blood donors and receptors in order to decrease the risk of alloimmunization. |
publishDate |
2010 |
dc.date.none.fl_str_mv |
2010-11-24 2015-07-22T20:50:15Z 2015-07-22T20:50:15Z |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
masterThesis |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
PINTO, Patrícia Costa Alves. Fenotipagem e aloimunização eritrocitária em portadores de anemia falciforme atendidos no Hemocentro de Alagoas. 2010. 66 f. Dissertação (Mestrado em Ciências) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2010. Tese-12392.pdf http://repositorio.unifesp.br/handle/11600/9650 |
dc.identifier.dark.fl_str_mv |
ark:/48912/0013000017xd3 |
identifier_str_mv |
PINTO, Patrícia Costa Alves. Fenotipagem e aloimunização eritrocitária em portadores de anemia falciforme atendidos no Hemocentro de Alagoas. 2010. 66 f. Dissertação (Mestrado em Ciências) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2010. Tese-12392.pdf ark:/48912/0013000017xd3 |
url |
http://repositorio.unifesp.br/handle/11600/9650 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
66 p. application/pdf |
dc.publisher.none.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) |
publisher.none.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UNIFESP instname:Universidade Federal de São Paulo (UNIFESP) instacron:UNIFESP |
instname_str |
Universidade Federal de São Paulo (UNIFESP) |
instacron_str |
UNIFESP |
institution |
UNIFESP |
reponame_str |
Repositório Institucional da UNIFESP |
collection |
Repositório Institucional da UNIFESP |
repository.name.fl_str_mv |
Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP) |
repository.mail.fl_str_mv |
biblioteca.csp@unifesp.br |
_version_ |
1818602591101124608 |