Development of anti-idiotypic antibodies in a patient with a factor VIII autoantibody

American Journal of Hematology
C TiarksR E Humphreys

Abstract

Antibodies against coagulation factor VIII were detected in a 33-year-old who developed severe bleeding 2 months postpartum. After treatment with plasmapheresis and immunosuppressive agents, the inhibitor was no longer detectable, but anti-idiotypic antibodies were detected, as demonstrated by binding in immunoradiometric assays, and by in vitro neutralization of the initial factor VIII autoantibodies. The anti-idiotypic titer subsequently declined but was still detectable 1 year later. Three commercial immunoglobulin preparations and pooled multiparous IgG also bound to (but did not neutralize) the patient's factor VIII antibody. These studies suggest that anti-idiotypic antibodies, arising in the face of immunosuppressive therapy, might suppress autoimmunity to factor VIII and confirm the presence of anti-idiotypic antibodies in pooled normal immunoglobulins.

Citations

Nov 1, 1990·Proceedings of the National Academy of Sciences of the United States of America·B C Lubahn, H M Reisner
Dec 29, 2000·Obstetrical & Gynecological Survey·S A ShobeiriT E Nolan
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Jan 1, 1991·Annals of the New York Academy of Sciences·C K Kasper
Dec 1, 2004·Haemophilia : the Official Journal of the World Federation of Hemophilia·Y-W HuangC Philipp

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