Association of ulcerative colitis and red blood cells coated with autoimmune antibody

Summary

A young woman with chronic ulcerative colitis, rheumatic heart disease, and mild diabetes mellitus, and who had not had any blood transfusions, developed an autoimmune antibody directed against her own erythrocytes with positive-direct and negative-indirect Coombs' tests. The antibodies disappeared after total colectomy, but were not affected by partial removal of the colon. No circulating anticolon antibodies could be demonstrated in the patient's serum, nor were antinuclear antibodies detected by L.E. cell preparations, nucleoprotein-coated latex particles, or by fluorescent antibody technics. Since the antibodies coating the red cells were specific for the molecular structure of the antigens e and f, it is suggested that they developed following absorption of damaged red cells through the ulcerated colonic mucosa and that antibody production stopped when this process was abolished by total colectomy.