THE IMPROVED DEMONSTRATION OF CIRCULATING ANTIBODIES IN HEMOLYTIC ANEMIA BY THE USE OF A BOVINE ALBUMIN MEDIUM

1. Bovine albumin solution as a testing and diluting medium was used for thedetection of abnormal iso-antibodies in the serum of various cases of hemolyticanemia.

2. Five patients with idiopathic acquired hemolytic anemia all showed a warmagglutinin, although in 4 of these patients antibody could not be detected by use ofthe standard saline technic. Higher titres than in salt sDlution were always obtained in the albumin medium. Three patients with congenital spherocytic anemianot in crisis, 2 patients with severe Mediterranean anemia, and 2 with sickle cellanemia failed to show antibody. In the crisis of 1 case of congenital spherocyticanemia an autohemolysin was temporarily found with the use of bovine albumin.Other cases of acquired hemolytic anemia (chemical, symptomatic, hypersplenic)failed to show antibody. Detection of antibody was of distinct value in the diagnosis of acquired hemolytic anemia of the "idiopathic" type. Its continuedpresence in such a case after splenectomy rendered the prognosis doubtful.

3. In the further differentiation of various types of familial and acquired cases,use was made of the red cell survival time. Parallel determinations of the survivaltime and of iso-antibodies showed a distinct correlation. Use of the anti-humanglobulin rabbit serum test to detect iso-antibody adsorbed to the red cell is citedas of further diagnostic aid.