Cold antibody

[catm]

We have a group O patient who has irregular results by Ortho  IAT. 14 out of 22 cells are reactive (+) to 2+ reactions (all normal antibodies ruled out) The auto is negative and DAT is  neg, In the RT direct tube tests all panel cells plus Oi cord sample are positive 2+ but the auto control is negative. Could this be an anti-H or would you expect stronger reactions?  We do not have anti-H available to test the patient. Also wondered about anti-Vel? 

[David Saikin]

Did you run more than one cord sample?  How about enzyme pretreated? I might be concerned that your reactions in gel have varying strengths - did you r/o anti-M?

 

 I just recently had a cold ab where the cord cells were 2+ at i.s., screening cells/auto: negative;  cord cells 4+ after 5 min @ r.t..  all the screening cells  1+ and auto: neg.  At 4C, cords were still 4+ other cells were 2+w including the auto.  This testing was done in tubes after all Ortho cells were 4+mf.  Peg/IgG screening in tubes - prewarmed- was very clean.  I ended up calling it an  anti-i plus a cold auto, specificity undetermined.  I also noted rouleaux at immediate spin in my reverse grouping.  The patient is B Pos;  backtyped as on O, but with saline replacement only the A cells reacted. 

 

Not much help, but you are not alone dealing with colds.

Edited October 28, 2014 by David Saikin

[Yanxia]

We have a group O patient who has irregular results by Ortho  IAT. 14 out of 22 cells are reactive (+) to 2+ reactions (all normal antibodies ruled out) The auto is negative and DAT is  neg, In the RT direct tube tests all panel cells plus Oi cord sample are positive 2+ but the auto control is negative. Could this be an anti-H or would you expect stronger reactions?  We do not have anti-H available to test the patient. Also wondered about anti-Vel? 

I prefer it is anti-H, if it is, it probably para-Bombay,. Does the reverse type with A1 and B cells show some differ with normal type O and what about react the patients plasma with his sibling or parents or children.

[galvania]

I think that if it were an anti-H you would have a bit more consistency with the Ortho panel cells.  You are going from negative to 2+ - that does seem to be a bit too much variation for an anti-H to me.  Also, if this were an anti-H and the auto-control is negative, then, as Shily said, you would be dealing with a para-Bombay or even a Bombay.  Have you sent it off to your reference centre?  If it really is a Bombay, then you really ought to know definitely