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Samenvatting 24-25 Hematologie 3 deel 4 : imuunhematologie $4.77
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Samenvatting 24-25 Hematologie 3 deel 4 : imuunhematologie

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Samenvatting vak hematologie deel 4 : immuunhematologie Gegeven in 3de jaar MLT

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  • December 22, 2024
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  • 2024/2025
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HEMATOLOGIE 3:
DEEL 4 : IMMUUNHEMATO
Lector. Flies Reinoud


Academiejaar
2024 - 2025




0

,INHOUD

1. Antistoffen – Antigenen ................................................................................................................................ 2

2. ABO-systeem ................................................................................................................................................ 7

3. Rhesus systeem........................................................................................................................................... 11

4. Andere bloedgroepen ................................................................................................................................. 13

5. Bloedgroepsystemen met hoogfrequente en laagfrequente antigenen ........................................................ 14

6. Antiglobulinetest......................................................................................................................................... 15

7. Hemolytische Ziekte van de Pasgeborene (HDN).......................................................................................... 16

8. Bloed en bloedderivaten ............................................................................................................................. 17

9. Kruisproeven............................................................................................................................................... 22

10. Type en screen .......................................................................................................................................... 27




1
Moons N / Vermeulen A

, 1. ANTISTOFFEN – ANTIGENEN
Zelfde PPT als vorig jaar → Groot deel is dus overgenomen uit SV Immuunhematologie 2

1.1 BLOEDGROEP ANTIGENEN

• = substanties die kunnen reageren met specifieke antistof
• Immunogeen = kunnen s opwekken
• Ag + As = hemolyse/agglutinatie
• Epitopen = 3D geordende structurele groep

1.1.1 BLOEDGROEPANTIGENEN
= eiwitten of suikers die zich bevinden op dragermoleculen in RBC-membraan, meestal membraaneiwitten of
lipiden

We hebben verschillende dragermoleculen. We onderscheiden er 3 :

• Single pass → ABO
→ gaan één keer door membraan

• Multi pass → Rh
→ gaan meerdere keren door membraan

• GPI linked → Dombrock




1.1.2 ANTIGEN EXPRESSIE
• Expressie van bloedgroep Ag wisselt sterk onder verschillende bloedgroepsystemen
• Ag niet altijd vanaf geboorte → bloedgroep kan nog veranderen

Dosage effect : reactie met van overeenstemmende Al met homozygote cellen is sterker dan heterozygote
→ Anti-M bij : MM (++) , MN (+)

Antigen suppressie : C in trans-positie in staat D te onderdrukken
→ CDe / cDe

Silent allelen (O) : genen die niet in staat zijn Ag te produceren

1.1.3 IMMUNOGENICITEIT
Immunogeniciteit = potentie van bepaald Ag om bij bepaald individu de overeenstemmende Al op te wekken

Zullen niet allemaal in zelfde maten Al opwekken
Sterkste : ABO > D >> K > E/c >> Fy >>> Jka : Zwakste
Opm
• Kidd en Kell zullen niet altijd Al opwekken
• Immunisatie is afhankelijk van blootstelling → meer contact = meer kans op Al vorming
• Transfusie VS zwangerschap
o Transfusie : grote hoeveelheid bloed
o Kleine hoeveelheid bloed doorheen placenta

2
Moons N / Vermeulen A

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