ICMR-NIIH Practical Guide to Laboratory Immunohematology
ICMR-NIIH Practical Guide to Laboratory Immunohematology
Editor Shrimati Dharmapal Shetty PhD
Scientist F/Deputy Director (SG) ICMR-National Institute of Immunohematology Mumbai, Maharashtra, India
Forewords Kanjaksha Ghosh MD
Manisha Madkaikar MD

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ICMR-NIIH Practical Guide to Laboratory Immunohematology
First Edition: 2020
9789386322470
Printed at:
- Ajit Gorakshakar PhD
- Ex-scientist F
- ICMR-National Institute of Immunohematology
- Mumbai, Maharashtra, India
- Ajaykumar Donta MSc
- Research Fellow
- ICMR-National Institute of Immunohematology
- Mumbai, Maharashtra, India
- Anita Nadkarni PhD
- Scientist F ICMR-National Institute of Immunohematology
- Mumbai, Maharashtra, India
- Aruna Shankarkumar PhD
- Scientist E
- ICMR-National Institute of Immunohematology
- Mumbai, Maharashtra, India
- Babu Rao Vundinti PhD
- Scientist F
- ICMR-National Institute of Immunohematology
- Mumbai, Maharashtra, India
- Bhavik Dalal MSc
- Research Fellow
- ICMR-National Institute of Immunohematology
- Mumbai, Maharashtra, India
- Bipin Kulkarni PhD
- Scientist D
- ICMR-National Institute of Immunohematology
- Mumbai, Maharashtra, India
- Disha Purchure MSc
- Research Fellow ICMR-National Institute of Immunohematology
- Mumbai, Maharashtra, India
- Harita Gogri MSc
- Research Fellow
- ICMR-National Institute of Immunohematology
- Mumbai, Maharashtra, India
- Malay Mukherjee PhD
- Scientist F
- ICMR-National Institute of Immunohematology
- Mumbai, Maharashtra, India
- Manisha Madkaikar MD
- Scientist G
- ICMR-National Institute of Immunohematology
- Mumbai, Maharashtra, India
- Maya Gupta MSc
- Technical Officer
- ICMR-National Institute of Immunohematology
- Mumbai, Maharashtra, India
- Nikesh Kawankar MSc
- Technical Assistant
- ICMR-National Institute of Immunohematology
- Mumbai, Maharashtra, India
- Pallavi Mehta MSc
- Laboratory Technician
- ICMR-National Institute of Immunohematology
- Mumbai, Maharashtra, India
- Prabhakar Kedar PhD
- Scientist E
- ICMR-National Institute of Immunohematology
- Mumbai, Maharashtra, India
- Prashant Warang PhD
- Technical Officer
- ICMR-National Institute of Immunohematology
- Mumbai, Maharashtra, India
- Priya Hariharan MSc
- Research Fellow
- ICMR-National Institute of Immunohematology
- Mumbai, Maharashtra, India
- Roshan Shaikh MSc
- Research Fellow
- ICMR-National Institute of Immunohematology
- Mumbai, Maharashtra, India
- Rucha Patil PhD
- Scientist B
- ICMR-National Institute of Immunohematology
- Mumbai, Maharashtra, India
- Seema Jadhav MSc
- Technical Officer
- ICMR-National Institute of Immunohematology
- Mumbai, Maharashtra, India
- Seema Korgaonkar PhD
- Technical Officer
- ICMR-National Institute of Immunohematology
- Mumbai, Maharashtra, India
- Sharda Shanbhag MSc
- Technical Officer
- ICMR-National Institute of Immunohematology
- Mumbai, Maharashtra, India
- Shrimati Dharmapal Shetty PhD
- Scientist F/Deputy Director (SG)
- ICMR-National Institute of Immunohematology
- Mumbai, Maharashtra, India
- Somprakash Dhangar MSc
- Technical Assistant
- ICMR-National Institute of Immunohematology
- Mumbai, Maharashtra, India
- Swati Kulkarni PhD
- Scientist E
- ICMR-National Institute of Immunohematology
- Mumbai, Maharashtra, India
- Vandana Pradhan PhD
- Scientist C
- ICMR-National Institute of Immunohematology
- Mumbai, Maharashtra, India
Medical science is an ever-changing science and its canopy is colored by differences in the prevalence of various conditions in different parts of the world. How a disease affects the population in question depends on genetic identity, exposure, nutritional status, traditions, substance abuse, prevalent practices and so on. Any science to be called “science” must lend to objective measurement which is done using simple scale, measuring tape or weighing balance. This can also be done in a simple test format in the bedside or in a more comprehensive way in the medical laboratories. There is no escape from these investigations, if an accurate diagnosis, prognosis or selection of a particular therapy is to be adopted. The laboratory medicine like other areas of medicine is continuously evolving. Blood is one of the most extensively investigated components in any disease condition.
The branch of medicine which directly deals with blood and related disorders is Hematology and Immunohematology. Most of the modern laboratory medicine books from the West which are published today provide the most current formats of investigations specific to those countries. Many of these investigations are machine-intensive and require specific reagents. This may bring uniformity and accuracy in the results but also increases the cost of these investigations. Many tests which are obsolete in Western countries may still be relevant in our country. The book along with the modern techniques also includes some of these cost-effective techniques developed by the scientists over the last 60 years. Serial evolution of some of the techniques like flow cytometry, molecular biology have also been chronicled in the book. The major objective is to provide to countless medium and small medical laboratories in India a handbook which will allow them to develop these techniques in their respective laboratories.
I am sure in spite of several laboratory medicine books in the market, this book will fill up the important gaps. Students from superspecialty courses like DM in Hemato-oncology, Laboratory Hematology, Clinical Hematology and MD in Transfusion Medicine, Pathology, Laboratory Medicine, Technologists and Scientists working in the field will find this highly useful. The book should find its place in all medical libraries and on the table of each student willing to pursue in these areas of medicine.
Kanjaksha Ghosh MD
Former Director
ICMR—National Institute of Immunohematology Mumbai, Maharashtra, India
Foreword
ICMR-NIIH Practical Guide to Laboratory Immunohematology is not only a practical manual but sharing of more than 60 years of experience to simplify diagnostic aspects of various inherited as well as acquired hematological and immunological disorders. The book not only focuses comprehensively on detailed protocols used for the diagnosis of various immunohematological diseases but also gives approach to the diagnosis of some of the complex disorders and critical steps for analysis and interpretation of the results. These protocols have been tested and brought to perfection by the authors with several years of experience in the field.
Dr Shrimati Dharmapal Shetty and the entire team of ICMR-NIIH including scientists, technical staff and students have painstakingly prepared this manual. I am sure it will be extremely useful not only for laboratory personnel but also for the clinicians and medical students interested in the field of Immunohematology. The cases discussed at the end of the protocols will help in understanding the applications and interpretations of the various techniques.
I congratulate all those who contributed to this unique manual and I am sure it will become an integral part of all Immunohematology laboratories and the Medical college libraries across India. I hope that this book will become a primer for teachers, teacher educators, and students across the country to learn, teach, and practice the subject of Immunohematology.
Manisha Madkaikar MD
Director
ICMR—National Institute of Immunohematology
Mumbai, Maharashtra, India
Preface
The book is the result of a long-standing determination to compile the laboratory protocols established in the Institute, i.e. both the phenotypic and genotypic investigations over the last 50 years. It is not only the contributors shown in the first few pages of the book, but each student and staff member who has worked for the Institute has an indirect role in the final formulation of the book.
A wide range of techniques and methods are available in biomedical research and these methods should be precise and reproducible. The book has a unique combination of chapters on a wide range of immunohematological disorders. It involves laboratory and genetic diagnostic protocols for both common and uncommon hematological disorders. The book is compiled from a series of notes and protocols of people practically involved with the diagnostics of different areas of immunohematology for several decades. The goal of the book is to offer the reader a quick and updated laboratory protocols and diagnostic algorithms of a series of immunohematological disorders, so that interested laboratory scientists or technical experts can establish these techniques in their respective laboratories without additional training. The book is an invaluable reference even for clinicians who are directly involved in the diagnosis and analysis of immunohematological disorders.
The attempt to bring out a book on a wide range of techniques in immunohematology research would not have been possible without the valuable and expert contributions of several members of the staff of the Institute who have first-hand experience with these methods. I am grateful to all my colleagues for their active cooperation in bringing out this book.
Our efforts only get rewarded if this book is read, used and appreciated by clinicians, researchers, and technicians all over and found it highly useful and practically implementable in their respective laboratories.
Shrimati Dharmapal Shetty PhD
Acknowledgments
This book is the result of the work of several dedicated individuals. First, I would like to thank all the Senior Scientists at ICMR-National Institute of Immunohematology i.e. Dr Manisha Madkaikar and Ms Maya Gupta, Department of Pediatric Immunology, Dr Baburao V, Department of Cytogenetics, Dr Malay Mukherjee, Dr Anita Nadkarni, and Dr Prabhakar Kedar, Department of Hematogenetics, Dr Aruna Shankarkumar, Department of Transfusion Transmitted Diseases, Dr Swati Kulkarni, Department of Transfusion Medicine, Dr Vandana Pradhan and Dr Seema Korgaonkar, Department of Autoimmune Disorders, Dr Bipin Kulkarni and Dr Rucha Patil, Department of Hemostasis and Thrombosis for their invaluable input in bringing out this book. I am highly indebted to all the research fellows, technical staff and students of the Institute for their valuable contribution in formulating this book. The book would not have been completed without the active support of my other colleagues in the Institute and my family members.
I would like to thank Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Managing Director), Ms Chetna Malhotra Vohra (Associate Director-Content Strategy) and the staff of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, for their whole hearted support and encouragement in publishing the book.
Introduction
ICMR-NIIH Practical Guide to Laboratory Immunohematology is intended for a wide range of academicians who work in the area of life sciences, i.e. scientists, laboratory personnel, undergraduates, graduates, postgraduates, clinicians, and professors alike, as a reference manual. The book deals with both laboratory and genetic diagnostic protocols on a wide range of subjects in the area of Immunohematology ranging from Hemoglobinopathies, Hemostasis and Thrombosis, Cytogenetics, Transfusion Medicine and Transfusion Transmitted Disorders, Autoimmune Disorders, and Primary Immunodeficiencies.
Though the focus is mainly on technical protocols, the unique feature of the book is its potential utility for both laboratory and genetic diagnosis along with theoretical information in each of these areas which is mainly directed to students to get basic information about the topics. Often, the technical protocols are being picked from standard books and then passed through generations, without imbibing the basic principles of the techniques. As a result, when an unusual case is encountered, the basic reasoning for these observations and even the options for modification of these protocols get limited. Laboratory Immunohematology under one roof provides not only the laboratory protocols but also the basic principles of protocols, diagnostic algorithms for complex disorders, unique case presentations, and their diagnostic approaches. Many of the protocols for genetic diagnosis of these disorders are not published widely and thus this part is a useful addition in the book.
The authors also have added the protocols of several in-house, cost-effective techniques as also the modifications of basic techniques established in the laboratory over the last several years which are published in various national and international journals. In short, the book provides extremely useful information on a unique combination of disorders in the area of Immunohematology.