BACKGROUND AND OBJECTIVES: Antibodies to immunoglobulin A (IgA) molecules are thought to be frequently responsible for anaphylactic reactions in transfusion medicine, but practical tests for the detection of antibodies to IgA are not yet available. MATERIAL AND METHODS: Red, high-density polystyrene beads were coated with purified IgA molecules and then used to test serum samples collected from unselected healthy blood donors (n = 105) and patients with common variable immunodeficiency and/or IgA deficiency (n = 44). For testing, the standard gel-agglutination technique (ID-Micro Typing System) was employed. RESULTS: None of the normal serum samples were reactive with IgA-coated beads and samples from only 10 patients were positive (titre range 1 : 2 to 1 : 256). Only one out of all patients studied had a history of an anaphylactic reaction and this was related to the administration of Rh(D) prophylaxis (anti-D immunoglobulin). The beads did not show non-specific agglutination and could be used repeatedly for longer than 6 months. The results were reproducible in all patients tested. CONCLUSION: The new test allows a specific and rapid detection of antibodies to IgA molecules. In order to evaluate the clinical relevance of the test, analysis is required of a wider range of antibodies that produce anaphylactic reactions.
BACKGROUND AND OBJECTIVES: Antibodies to immunoglobulin A (IgA) molecules are thought to be frequently responsible for anaphylactic reactions in transfusion medicine, but practical tests for the detection of antibodies to IgA are not yet available. MATERIAL AND METHODS: Red, high-density polystyrene beads were coated with purified IgA molecules and then used to test serum samples collected from unselected healthy blood donors (n = 105) and patients with common variable immunodeficiency and/or IgA deficiency (n = 44). For testing, the standard gel-agglutination technique (ID-Micro Typing System) was employed. RESULTS: None of the normal serum samples were reactive with IgA-coated beads and samples from only 10 patients were positive (titre range 1 : 2 to 1 : 256). Only one out of all patients studied had a history of an anaphylactic reaction and this was related to the administration of Rh(D) prophylaxis (anti-D immunoglobulin). The beads did not show non-specific agglutination and could be used repeatedly for longer than 6 months. The results were reproducible in all patients tested. CONCLUSION: The new test allows a specific and rapid detection of antibodies to IgA molecules. In order to evaluate the clinical relevance of the test, analysis is required of a wider range of antibodies that produce anaphylactic reactions.