{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T15:54:33Z","timestamp":1765382073726,"version":"3.41.2"},"reference-count":8,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,5,31]],"date-time":"2017-05-31T00:00:00Z","timestamp":1496188800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Laboratory Analysis"],"published-print":{"date-parts":[[2018,2]]},"abstract":"Background<\/jats:title>The Monocyte Monolayer Assay (MMA<\/jats:styled-content>) is an in vitro simulation of red blood cell (RBC<\/jats:styled-content>) alloantibody behavior. It has been classically applied to predict the risks of post\u2010transfusion hemolytic reactions when transfusing incompatible RBC<\/jats:styled-content> units. Quantifying erythrophagocytosis by MMA<\/jats:styled-content> may be an interesting option for situations where there is doubt whether a RBC<\/jats:styled-content> autoantibody is mediating significant hemolysis. Here, we present three situations involving RBC<\/jats:styled-content> autoantibodies in which the MMA<\/jats:styled-content> was decisive for clarifying the diagnosis and choosing the best clinical treatment.<\/jats:p><\/jats:sec>Case Report<\/jats:title>Case 1<\/jats:italic>. Pregnant patient with severely anemic fetus exhibited warm autoantibody without signs of hemolysis. MMA<\/jats:styled-content> revealed 30% of monocyte index (MI<\/jats:styled-content>) highlighting that fetal hemolysis was caused by maternal autoantibody. Prednisone was prescribed with fetal clinical improvement. Cases 2 and 3<\/jats:italic>. Two patients with the diagnosis of mixed auto\u2010immune hemolytic anemia and poor response to corticosteroids were evaluated using MMA<\/jats:styled-content>. The resulting MI<\/jats:styled-content> was less than 10% in both cases, suggesting that the cold\u2010agglutinin rather than the warm auto\u2010IgG was responsible for overt hemolysis. Treatment with rituximab was begun, with good clinical response.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>MMA<\/jats:styled-content> can be used to evaluate the ability of RBC<\/jats:styled-content> autoantibodies to mediate overt hemolysis. It can be especially useful to determine the role played by cold and warm auto\u2010antibodies in mixed auto\u2010immune hemolytic disease, helping to define the best treatment option.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcla.22274","type":"journal-article","created":{"date-parts":[[2017,6,1]],"date-time":"2017-06-01T04:46:43Z","timestamp":1496292403000},"source":"Crossref","is-referenced-by-count":7,"title":["Defining the clinical relevance of red blood cell autoantibodies by Monocyte Monolayer Assay"],"prefix":"10.1002","volume":"32","author":[{"given":"Marina C. A. V.","family":"Conrado","sequence":"first","affiliation":[{"name":"Funda\u00e7\u00e3o Pr\u00f3\u2010Sangue Hemocentro de S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda N.","family":"D'Avila","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Pr\u00f3\u2010Sangue Hemocentro de S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juliana B.","family":"Vieira","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Pr\u00f3\u2010Sangue Hemocentro de S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia L.","family":"Bonifacio","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Pr\u00f3\u2010Sangue Hemocentro de S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco C. A.","family":"Gomes","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Pr\u00f3\u2010Sangue Hemocentro de S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcia R.","family":"Dezan","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Pr\u00f3\u2010Sangue Hemocentro de S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valeria B.","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Pr\u00f3\u2010Sangue Hemocentro de S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ingrid H.","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Pr\u00f3\u2010Sangue Hemocentro de S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luciana T. C. M.","family":"Tucunduva","sequence":"additional","affiliation":[{"name":"Discipline of Hematology University of S\u00e3o Paulo School of Medicine S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfredo","family":"Mendrone\u2010J\u00fanior","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Pr\u00f3\u2010Sangue Hemocentro de S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vanderson","family":"Rocha","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Pr\u00f3\u2010Sangue Hemocentro de S\u00e3o Paulo S\u00e3o Paulo Brazil"},{"name":"Discipline of Hematology University of S\u00e3o Paulo School of Medicine S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0453-7863","authenticated-orcid":false,"given":"Carla L.","family":"Dinardo","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Pr\u00f3\u2010Sangue Hemocentro de S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,5,31]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.1987.27688071692.x"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/tme.12189"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2004.03427.x"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.3233\/BIR-120621"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.00655.2013"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1006\/abio.1994.1066"},{"volume-title":"Molecular Protocols in Transfusion Medicine","year":"2000","author":"Denomme GA","key":"e_1_2_5_8_1"},{"key":"e_1_2_5_9_1","doi-asserted-by":"crossref","first-page":"6","DOI":"10.21307\/immunohematology-2019-691","article-title":"A maternal warm\u2010reactive autoantibody presenting as a positive direct antiglobulin test in a neonate","volume":"13","author":"Williamson TD","year":"1997","journal-title":"Immunohematology"}],"container-title":["Journal of Clinical Laboratory Analysis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjcla.22274","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcla.22274","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,26]],"date-time":"2023-09-26T20:17:54Z","timestamp":1695759474000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jcla.22274"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,5,31]]},"references-count":8,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2018,2]]}},"alternative-id":["10.1002\/jcla.22274"],"URL":"https:\/\/doi.org\/10.1002\/jcla.22274","archive":["Portico"],"relation":{},"ISSN":["0887-8013","1098-2825"],"issn-type":[{"type":"print","value":"0887-8013"},{"type":"electronic","value":"1098-2825"}],"subject":[],"published":{"date-parts":[[2017,5,31]]},"article-number":"e22274"}}