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pubmed-article:2756937pubmed:abstractTextPatients on chronic hemodialysis who are treated with reusable dialyzers sterilized with formaldehyde are known to have antibodies develop with N-like specificity. These sera have been shown to also react with formaldehyde-treated N-negative cells. This latter specificity has been referred to as antiformaldehyde (anti-Form). Because anti-Form develops presumably in response to formaldehyde-treated cells that gain access to the patient's circulation, the authors reasoned that recipient anti-Form once established might be capable of binding to cells exposed to formaldehyde during dialysis, resulting in a positive direct antiglobulin test (DAT) result and an eluate reacting only with formaldehyde-treated reagent cells. The authors studied 96 patients on chronic hemodialysis who were exposed to formaldehyde-sterilized equipment. Both anti-N-like and anti-Form specificities were found. Anti-Form was detected in the serum of 16% of patients when tested against 0.37% (w/v) formaldehyde-treated cells. Nineteen percent of patients demonstrated a positive DAT result. The presence of a positive DAT result was significantly associated with the presence of anti-Form in the patient's serum (P less than 0.05). Red blood cell eluates from two patients with a positive IgG DAT result and serum anti-Form demonstrated anti-Form in the eluate. Increasing the concentration of formaldehyde treatment of red blood cells resulted in increasing strength of reactions with anti-Form serum, suggesting that the sensitivity of serum and eluate testing could be modified by the method of cell preparation. As expected, the reactivity of anti-Form with formaldehyde-treated cells could not be neutralized by formaldehyde. The authors conclude that patients treated with formaldehyde-sterilized reusable dialysis equipment may on occasion have a positive DAT result and have an eluate that is nonreactive with the use of standard reagent cells but reactive with formaldehyde-treated cells.lld:pubmed
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pubmed-article:2756937pubmed:dateRevised2004-11-17lld:pubmed
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pubmed-article:2756937pubmed:articleTitlePositive direct antiglobulin test result in dialysis patients resulting from antiformaldehyde antibodies.lld:pubmed
pubmed-article:2756937pubmed:affiliationDepartment of Pathology, New England Deaconess Hospital, Boston, Massachusetts 02215.lld:pubmed
pubmed-article:2756937pubmed:publicationTypeJournal Articlelld:pubmed