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Transfus Apher Sci. 2011 Oct;45(2):199-202. doi: 10.1016/j.transci.2011.08.003. Epub 2011 Sep 1.

High frequency of autoimmunization among transfusion-dependent Tunisian thalassaemia patients.

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  • 1Service d'immuno-hématologie pédiatrique, Centre National de Greffe de moelle osseuse 2, rue Djebel Lakhdar, Bab Saadoun 1006, Tunis, Tunisie.



Limited data are available on the frequency of RBC alloimmunization and autoimmunization in transfusion-dependent Tunisian β thalassaemia patients.


We analyzed the clinical and transfusion records of 130 patients (57 females and 73 males; mean age 119 months; range 12-11 months) with β thalassaemia major and who had regular blood transfusions for periods ranging from 12 to 311 months.


Of the 130 patients, ten (7.7%) developed RBC alloantibodies. The most common alloantibodies were directed against antigens in the Rh systems. Erythrocyte-autoantibodies as determined by a positive direct antiglobulin Coombs test, developed in 52(40%) patients with and without underlying RBC alloantibodies, thereby causing autoimmune haemolytic anaemia in eleven patients (21%).


Autoimmunization to erythrocyte antigens is a frequent complication in patients with β thalassaemia major. Several factors might have contributed to the high autoimmunization rate observed in this study, including non phenotypic blood exposure and alloantibody formation prior to positive Coombs test.

Copyright © 2011 Elsevier Ltd. All rights reserved.

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