Anti N Antibody in a Patient of Renal Failure on Hemodialysis

  • Paramjit KaurEmail author
  • Sabita Basu
  • Gagandeep Kaur
  • Ravneet Kaur
  • Bankim Das
Case Report


Anti N is a rare antibody. It has been reported in renal failure patients on hemodialysis using formaldehyde sterilized equipment. Although anti N is usually clinically insignificant, rarely it can cause hemolytic transfusion reaction. Patients with clinically significant antibodies should receive N antigen negative red cell units. We report a case of anti N antibody active at 37 °C in a patient of chronic renal failure on regular maintenance hemodialysis. The present case is being reported mainly because of its detection during routine blood grouping and compatibility testing by tube method in a patient of chronic renal failure on regular maintenance hemodialysis.


Anti N antibody Renal failure Hemodialysis 


  1. 1.
    Howell ED, Perkins HA (1972) Anti N like antibodies in the sera of patients undergoing chronic hemodialysis. Vox Sang 23:291–299PubMedCrossRefGoogle Scholar
  2. 2.
    Harrison PB, Jansson K, Kronenberg H, Mahony JF, Tiller D (1975) Cold agglutinin formation in patients undergoing hemodialysis. A possible relationship to dialyser reuse. Aust N Z J Med 5:195–197PubMedCrossRefGoogle Scholar
  3. 3.
    Fassbinder W, Seidl S, Koch KM (1978) The role of formaldehyde in the formation of hemodialysis associated anti N like antibodies. Vox Sang 35:141–148CrossRefGoogle Scholar
  4. 4.
    Belzar FO, Kountz SL, Perkins HA (1971) Red cell cold autoagglutinins as a cause of failure of renal allotransplantation. Transplantation 11:422–424Google Scholar
  5. 5.
    Gorst DW, Riches RA, Renton PH (1977) Formaldehyde induced anti N: a possible cause of renal graft failure. J Clin Pathol 30:956–959PubMedCrossRefPubMedCentralGoogle Scholar
  6. 6.
    Sandler SG, Sharon R, Stessman J, Czaczkes JW (1978) Anti formaldehyde and anti N like antibodies in hemodialysis patients. Israel J Med Sci 14:1177–1180PubMedGoogle Scholar
  7. 7.
    Sandler SG, Sharon R, Bush M, Stroup M, Sabo M (1979) Formaldehyde related antibodies in hemodialysis patients. Transfusion 19:682–687PubMedCrossRefGoogle Scholar
  8. 8.
    Sharon R (1979) Reduced antibody response in patients with chronic renal failure undergoing hemodialysis with formaldehyde sterilized units. Transfusion 19:754–755PubMedCrossRefGoogle Scholar
  9. 9.
    Sharon R (1981) Relationship between formaldehyde related antibodies and cross reacting anti N like antibodies in patients undergoing chronic hemodialysis. J Clin Pathol 34:41–43PubMedCrossRefPubMedCentralGoogle Scholar
  10. 10.
    Garraty G (1998) In vitro reactions with packed red blood cells that are not due to blood group antibodies: a review. Immunohematology 14:1–11Google Scholar
  11. 11.
    Lynen R, Rothe M, Gallasch E (1983) Characterization of formaldehyde related antibodies encountered in hemodialysis patients at different stages of immunization. Vox Sang 44:81–89PubMedCrossRefGoogle Scholar
  12. 12.
    Ng YY, Chow MP, Wu SC, Lyou JY, Harris DC, Hirang TP (1995) Anti N-form antibody in hemodialysis patients. Am J Nephrol 15:374–378PubMedCrossRefGoogle Scholar
  13. 13.
    Roback JD, Grossman BJ, Harris T, Hillyer CD (2011) Technical manual. AABB, BethesdaGoogle Scholar
  14. 14.
    Poole J, Daniels G (2007) Blood group antibodies and their significance in transfusion medicine. Transfus Med Rev 21:58–71PubMedCrossRefGoogle Scholar
  15. 15.
    Dzik WH, Darling CA (1989) Positive direct antiglobulin test result in dialysis patients resulting from anti formaldehyde antibodies. Am J Clin Pathol 92:214–217PubMedGoogle Scholar
  16. 16.
    Fonseca HE, Chiba AK, Junior AF, Draibe SA, Bordin JO (2004) Anti N like and anti form red cell antibodies in chronic hemodialysis patients. Ren Fail 26:553–556PubMedCrossRefGoogle Scholar

Copyright information

© Indian Society of Haematology & Transfusion Medicine 2014

Authors and Affiliations

  • Paramjit Kaur
    • 1
    Email author
  • Sabita Basu
    • 1
  • Gagandeep Kaur
    • 1
  • Ravneet Kaur
    • 1
  • Bankim Das
    • 1
  1. 1.Department of Transfusion MedicineGovernment Medical College and Hospital, Sector 32ChandigarhIndia

Personalised recommendations