A patient with anti‐Co<sup>a</sup> having activated monocytes specifically phagocytosing <scp>IAT</scp>‐negative Co(a+) red blood cells
Bibliographic record
Abstract
Abstract Background The antigen, Coa(CO1), is a high prevalence antigen. There is not a substantial amount of evidence regarding the clinical significance of anti‐Coa, especially if this antibody can cause phagocytosis. Using the monocyte monolayer assay (MMA), we have investigated the potential clinical significance of anti‐Coa in a patient that appeared to have an activated mononuclear phagocyte system. Study Design and Methods A female, AB RhD‐negative patient having anti‐Coa was investigated for the potential clinical significance of the antibody using the MMA. On initial presentation, MMA using both autologous and allogeneic monocytes were performed using the following red blood cell (RBC) samples: four Co(a+), one Co(a−) autologous RBC, a positive control of RhD‐positive RBC opsonized with anti‐D and a nonopsonized RhD‐negative control. The patient's plasma was tested against all RBC samples by a saline‐IAT (sIAT). A DAT on the patient's RBC was performed using polyspecific and monospecific antihuman globulin sera The autologous MMA was performed initially on presentation and again, 2 months later. Results Initial autologous MMA showed significant phagocytosis with all 4 Co(a+) donors, despite the sIAT being nonreactive with both IgG and C3d. The RBCs from the Co(a−) donor did not show any phagocytosis. The patient had a negative tube DAT, however, was able to significantly phagocytize their own RBCs. Anti‐D‐opsonized RhD‐positive RBCs showed greatly enhanced phagocytosis compared to what is usually observed. Allogeneic MMA showed no significant phagocytosis. Follow‐up autologous MMA, 2 months later, when the patient was stable having a hemoglobin of 15.5 g/dL, showed similar results as the initial MMA using the dame donor RBCs as in initial testing; however, the patient's monocytes no longer gave a positive result with autologous RBCs. Discussion These results suggest an enhanced activation of the patient's monocytes that is specific for Co(a+) RBCs and indicate the anti‐Coa as potentially clinically significant.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".