nisar10281 Posted April 20, 2015 Share Posted April 20, 2015 Hello everybody,we had a case here in our blood bank,one OPD male patient age 25 years came to our hospital for arranging blood for his elective surgery,when we perform his blood group the reaction were as under, (we are using ortho Auto Innova in our blood bank glass beads technology) Anti A Anti B Anti D Rhc a1cells bcells Interp 0 0 4 0 0 4 ABO discrpancy. Blood group rechecked with tube technique and got the same result as above.Further ..... Two more sample were collected along with the XM sample at the same time for CBC and Urea, I checked both the samples and both were clear cut O positive with +4 with a1cells and +4 with bcells in reverse group.we asked for reacollection and with the new sample the result was group O Positive.this Patient came alone and all the three sample for XM ,Urea and CBC were collected at the same time.Anybody encounter a case like this,or is it possible?all the comments will be appreciated. Link to comment Share on other sites More sharing options...
David Saikin Posted April 20, 2015 Share Posted April 20, 2015 (edited) Seems odd for sure . . . Edited April 20, 2015 by David Saikin nisar10281 1 Link to comment Share on other sites More sharing options...
Dansket Posted April 20, 2015 Share Posted April 20, 2015 (edited) This is not that rare in ORTHO Gel. In 0.8% of 3500 adult plasma specimens tested from group O, A and B patients, expected anti-A and/or anti-B was not detected in the ABO Plasma Grouping test. One of thefundamental differences between column agglutination technology and standard test tube is the use of centrifugation. In column-agglutination, centrifugation is used to separate agglutinated rbcs from unagglutinated rbcs. In standard tube, centrifugation is used to enhance the antigen-antibody reaction. So some IgM antibodies may not react as well in 'columns' as they do in tube. I reported this in 1997 at the AABB meeting in Denver. Our standard approach is to repeat the ABO Plasma Grouping test in test tube. This resolves 80% of the discrepancies. Edited April 20, 2015 by Dansket nisar10281 1 Link to comment Share on other sites More sharing options...
David Saikin Posted April 20, 2015 Share Posted April 20, 2015 It seems that the test was repeated in tube with the same results . . . that is the conundrum. nisar10281 1 Link to comment Share on other sites More sharing options...
Dansket Posted April 20, 2015 Share Posted April 20, 2015 nisar10281: As I re-read this: anti-A not detected in patient plasma by Innova glass bead or by standard tube in 1st blood sample. Two additional blood samples collected: anti-A is detected in patient plasma by which method, Innova or Tube? Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted April 21, 2015 Share Posted April 21, 2015 Call me a cynic if you like, but I just wonder if the sample you received the first time really was drawn at the same time as those taken for the FBC and U&E, or whether the person drawing the blood was being somewhat "economical" with the truth? I also wonder if the sample was labelled at the bedside straight away, or whether it was labelled at the nursing station later, which, if any other patients' samples were also there, is a recipe for a wrong blood in tube type episode. I do not have a serological explanation for your findings. David Saikin, Sandy L and Yanxia 3 Link to comment Share on other sites More sharing options...
nisar10281 Posted April 22, 2015 Author Share Posted April 22, 2015 Seems odd for sure . . . Call me a cynic if you like, but I just wonder if the sample you received the first time really was drawn at the same time as those taken for the FBC and U&E, or whether the person drawing the blood was being somewhat "economical" with the truth? I also wonder if the sample was labelled at the bedside straight away, or whether it was labelled at the nursing station later, which, if any other patients' samples were also there, is a recipe for a wrong blood in tube type episode. I do not have a serological explanation for your findings.dear Malcolm all the three samples were collected at the same time,patient came as OPD patient to the sample collection area,I phenotyped the three samples and the phentype for all the three samples was ccEc Kell Neg. Malcolm Needs 1 Link to comment Share on other sites More sharing options...
nisar10281 Posted April 22, 2015 Author Share Posted April 22, 2015 nisar10281: As I re-read this: anti-A not detected in patient plasma by Innova glass bead or by standard tube in 1st blood sample. Two additional blood samples collected: anti-A is detected in patient plasma by which method, Innova or Tube?Dear Anti A was not detected by both method in the sample which was received for XM Malcolm Needs 1 Link to comment Share on other sites More sharing options...
Yanxia Posted April 22, 2015 Share Posted April 22, 2015 Maybe the first sample is been diluted by some fluid. Malcolm Needs 1 Link to comment Share on other sites More sharing options...
galvania Posted April 22, 2015 Share Posted April 22, 2015 How strong was the reaction with the A cells on the repeat samples? And were they tested using the same bottle of A cells (not just the same lot) as for the first testing? And was the first testing done manually and on the instrument using the same bottle of A cells? Malcolm Needs 1 Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted April 22, 2015 Share Posted April 22, 2015 Good questions Anna. Link to comment Share on other sites More sharing options...
nisar10281 Posted April 23, 2015 Author Share Posted April 23, 2015 Maybe the first sample is been diluted by some fluid YES WE WOULD THINK ABOUT DILUTION BUT THERE WAS +4 REACTION WITH b CELLS,SO Link to comment Share on other sites More sharing options...
nisar10281 Posted April 23, 2015 Author Share Posted April 23, 2015 How strong was the reaction with the A cells on the repeat samples? And were they tested using the same bottle of A cells (not just the same lot) as for the first testing? And was the first testing done manually and on the instrument using the same bottle of A cells?YES ANA BOTH THE BOTTLES OF THE A1 CELLS WERE THE SAME AND THE REACTION STRENGTH WAS +4 WITH REPEATED SAMPLES. Link to comment Share on other sites More sharing options...
nisar10281 Posted April 23, 2015 Author Share Posted April 23, 2015 THANKS TO ALL FOR THEIR VALUABLE COMMENTS Link to comment Share on other sites More sharing options...
Yanxia Posted April 24, 2015 Share Posted April 24, 2015 Somebody's anti-A and anti-B is not in the same level, or quanlity, so dilution maybe influence the weak one more in agglutination reaction strength. Link to comment Share on other sites More sharing options...
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