SRMC BB Posted August 3, 2014 Share Posted August 3, 2014 I have a cord blood that is typing as follows: A 4+ B 1+ weak, but it's there D 4+ DAT is negative; mom is O pos. Repeated type on a venipuncture and it repeated the same. I reported unable to type; DAT negative Any suggestions........ TIA,Natalie Link to comment Share on other sites More sharing options...
Dansket Posted August 3, 2014 Share Posted August 3, 2014 Which test method are you using, gel, tube? Did you run an Rh control? Link to comment Share on other sites More sharing options...
SRMC BB Posted August 3, 2014 Author Share Posted August 3, 2014 tube method; Rh control neg Link to comment Share on other sites More sharing options...
Dansket Posted August 3, 2014 Share Posted August 3, 2014 Is this a microscopic reading of the anti-B test (if so was the Rh control read microscopically as well)? Are you using a monoclonal anti-B? Do you have access to other anti-B antiserum? Link to comment Share on other sites More sharing options...
Mabel Adams Posted August 4, 2014 Share Posted August 4, 2014 Is baby healthy? No infections causing acquired B antigen? Is baby not genetic child of mom--donor egg? Assuming mom is mom, once you get the same results with another anti-B reagent, is Dad of baby around to be typed? Link to comment Share on other sites More sharing options...
AMcCord Posted August 4, 2014 Share Posted August 4, 2014 Was the cord blood labeled correctly? (wrong blood in tube?) Did you get a capillary sample and retest? If you can rule out everything by using Dansket & Mabel's 'to do' lists, consider cis-AB. Link to comment Share on other sites More sharing options...
SRMC BB Posted August 4, 2014 Author Share Posted August 4, 2014 Is this a microscopic reading of the anti-B test (if so was the Rh control read microscopically as well)? Are you using a monoclonal anti-B? Do you have access to other anti-B antiserum?Macroscopic reading of Anti-B and Rh control. using monoclonal anti-B. Don't have access to another anti-B antisera Is baby healthy? No infections causing acquired B antigen? Is baby not genetic child of mom--donor egg? Assuming mom is mom, once you get the same results with another anti-B reagent, is Dad of baby around to be typed?Baby was born with 102 degree fever; mom had fever and foul smelling amniotic fluid per the nurses; culture obtained from placenta; Blood culture drawn from baby just after delivery As of right now, blood culture is negative on baby. Was the cord blood labeled correctly? (wrong blood in tube?) Did you get a capillary sample and retest? If you can rule out everything by using Dansket & Mabel's 'to do' lists, consider cis-AB.Cord was labeled correctly (only delivery at that time and I was up in OB while nurse was obtaining cord blood sample. We did not get a capillary sample since we did a venipuncture on baby for a blood culture and a CBC. Where can I find Dansket and Mabel's to do lists? I'm not familiar with them. Link to comment Share on other sites More sharing options...
Dansket Posted August 4, 2014 Share Posted August 4, 2014 "Where can I find Dansket and Mabel's to do lists? I'm not familiar with them." They are in our posts responding to your inquiry. Ultimately, you may have to wait until blood samples can be obtained in the future when baby is healthy and older.. Link to comment Share on other sites More sharing options...
AMcCord Posted August 4, 2014 Share Posted August 4, 2014 "Where can I find Dansket and Mabel's to do lists? I'm not familiar with them." They are in our posts responding to your inquiry. Ultimately, you may have to wait until blood samples can be obtained in the future when baby is healthy and older.. Agree. The problem may be resolved later with another sample from a healthier baby. Obviously a infection going on with foul smelling amniotic fluid, so that could be some or all of what's messing up the cord type. Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted August 5, 2014 Share Posted August 5, 2014 It could well be resolved later, as it could just be down to enzyme competition. ABO antigens are not inherited. What is inherited are the genes that produce the enzymes that transfer the immunodominant sugars from a uridine donor molecule onto the subterminal sugar residue of the ABO "backbone" molecule. In the case of a newborn, there is constant enzymic competition between the N-acetyl-D-galactosaminyl transferase (attaching the A immunodominant sugar residue to the H molecule) and the D-galactosyl transferase (attaching the B immunedominant sugar residue to the H molecule), often leading to a stronger A antigen than B antigen, or a stronger B antigen than A antigen, depending upon which of the 2 enzymes is "winning" the competition. AS the enzymes reach their respective kinetic maximum, the competition tends to resolve, and the antigens also tend to match each other in strength (although, because there is still some competition, and there is only a finite number of H sites, and because the genes tend to be codominant) the A antigen never quite reaches the strength of an A1 individual, and the B antigen never quite reaches the strength of a B individual (although this can usually only be detected by titration). tricore 1 Link to comment Share on other sites More sharing options...
Sko681 Posted August 5, 2014 Share Posted August 5, 2014 Ok nobody kill me for suggesting this... Do you know the fathers blood type? I remebered this article from years back and had to share! You can find it on Medscape. A case study of cis-AB. "Incidence of a Type AB Infant Born to a Type O Mother" LabMed.2006;37(1):28-35 Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted August 5, 2014 Share Posted August 5, 2014 Nobody, but NOBODY, should, or would (I hope) kill anyone for putting forward a view on this site, and if they do (even metaphorically) I, for one, am leaving it (and that is the very last thing I want to do - I'm learning so much! Sko681 1 Link to comment Share on other sites More sharing options...
Mabel Adams Posted August 7, 2014 Share Posted August 7, 2014 Malcolm, wasn't the mom group O? That would reduce the likelihood that the baby is a typical AB with warring enzymes. Cis-AB, donor egg, mom is actually Bombay or??? I'm leaning toward acquired B antigen due to the infection. Maureen, Malcolm Needs and Yanxia 3 Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted August 7, 2014 Share Posted August 7, 2014 Oh Lord, I missed that Mabel. I think that You are right! Link to comment Share on other sites More sharing options...
EDibble Posted August 20, 2014 Share Posted August 20, 2014 Ok nobody kill me for suggesting this... Do you know the fathers blood type? I remebered this article from years back and had to share! You can find it on Medscape. A case study of cis-AB. "Incidence of a Type AB Infant Born to a Type O Mother" LabMed.2006;37(1):28-35 Really interesting article. Thanks! Link to comment Share on other sites More sharing options...
AMcCord Posted August 20, 2014 Share Posted August 20, 2014 One of our near neighbor hospitals had a cis-AB baby - I think it might be the case in the reference you cited. They really had fun with that one. The newspaper there even published a front page story about the baby with the rare blood type with pictures, interviews, the works. One of the few times the rest of the world gets interested in what we do. Link to comment Share on other sites More sharing options...
SRMC BB Posted August 22, 2014 Author Share Posted August 22, 2014 Ok nobody kill me for suggesting this... Do you know the fathers blood type? I remebered this article from years back and had to share! You can find it on Medscape. A case study of cis-AB. "Incidence of a Type AB Infant Born to a Type O Mother" LabMed.2006;37(1):28-35 No....we don't know the father's blood type. Even if we tested who mom said was the dad, we (blood bank) can't be sure that he's the baby daddy... Malcolm, wasn't the mom group O? That would reduce the likelihood that the baby is a typical AB with warring enzymes. Cis-AB, donor egg, mom is actually Bombay or??? I'm leaning toward acquired B antigen due to the infection. I'd love to get a sample one the baby got a little older, but don't know if the doctor would order or has even told the mom that we couldn't get a type. "Where can I find Dansket and Mabel's to do lists? I'm not familiar with them." They are in our posts responding to your inquiry. Ultimately, you may have to wait until blood samples can be obtained in the future when baby is healthy and older.. I didn't realize you were referring me to your quotes....sorry it had been a long day Thanks!! Link to comment Share on other sites More sharing options...
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