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Here is a follow up. The baby had tested with anti-A on 27, April and transfused with O washed cells the same day, but on 10, May she had no anti-A and received A type packed red cells with no transfusion reaction. She has stoped feeding on her mother's milk for 14 days. I tried to persuade her mother to do some tests. The results came out and she has no anemia, with normal reticulocyte count and percentage. Her bilirubin and LDH are normal too. But she has not tested her haptoglobin. She has not received any blood transfusion and IVIG. She just diagnosed with slight anemia during pregnancy and after birth. She had taken iron supplements during pregnancy,. This is her eventh pregnancies and the third baby, she had several miscarriages. She told me her case seems like a mystery both to her and the doctors she know. She just want to know if she is ok and the baby will be healthy in the future.

We just started using the new Ortho Vision coming from manual tube method. We saw an increase of Anti-D positive (negative patient history) as the gel are more sensitive. We repeat the test with the now back-up tube method (negative result) and just report as negative for the anti-D. My question is, what is your blood bank policy in handling these discrepant result between the gel and the tube method? Do you just report as negative or do you change it to positive? Thank you.

Regardless of gender, we do a weak D tube test on any patient who test at 2+ or below with the Ortho gel anti-D. If patients are possible weak D, we will transfuse with Rh negative as a precaution.

For gel 2+ or less, we ask provider to allow us to send out for molecular typing if patient has childbearing potential. Otherwise, we usually interpret them as D positive but add a note that their type is weak and atypical so they may sometimes be reported as negative and other times (other places) as positive. If they have anti-D or some other reason (anti-C & anti-E?) we will choose to call them D neg.

She is still breast feeding the baby, and looks healthy.

When gel was our primary testing method a reaction w anti-D of 1+ or less was called Rh negative. I know of folks who call 3+ rxs or weaker Rh negative. This was determined by the Medical Director.

Thank you very much, Arno. Only one question left, why does the mom asymptomatic even with auto anti-A. We have encountered another case of auto anti-A, that one need transfusion.

We do similar to labguru. We went from manual tube to automated gel (BioRad) and have found the same thing. If we have a discrepancy we send it out for genotyping. Most come back as a weak D type 1 (or 2 or 3). I am considering doing a manual tube type on our females less than 45 when they type as Rh positive the first time. And then sending out any discrepancies for genotyping. sandra

We do not do the testing in tube to confirm. We will send the sample to American Red Cross for Genotyping for RHD variants if the reaction is 1-2+. The majority come back as weak D type 1 and are not considered to be at risk for production of allo-anti-D. It is generally accepted that females of child-bearing potential with weak D type 1 can be considered D positive for transfusion and are not candidates for Rh immune globulin. Their type will be updated with that comment. If the patient comes back as one of the other weak D types and there is a chance for production of the allo-anti-D, we will leave it as Rh negative and put the comment that testing was done in the patient history.

What you say has made me doubt it is anti-FORS1, as the FORS1 antigen is relatively rare in a human, so being positive with all five cases of group A would be highly unusual. I just wondered, but I think I am wrong. I doubt that it is Tn. It may be, but you can test this by using Dolichos biflorus, which would be positive with Tn activated red cells, while human-derived anti-A1 would be negative. Come what may, it is a VERY interesting case. THANK YOU for sharing it.

Thanks, Malcom. 1. I am not sure it is.anti-A, not.anti-A1. I mathed 5 A donors with the patient and the reactions.are all positive(Maybe they all A1). It is my fault, I need to add A2 cells to make sure about it. 2. I searched about the FORS1 online, there are few papers I can find. I will try my books tomorrow. This.is the.first time I read this antigen. Is there any cross reaction between it and A( or A1) antigen? 3. There is an idea just poped on my mind, it maybe Tn. But I don't know if Tn can give so strong reaction with monoconal anti-A reagent.

Here is where we landed.

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Hi @Emmanuel Akomanin Asiamah, You can create a new post about histotechnology or cytotechnology. Maybe a new efficiency you come up with in testing, equipment issues, trouble finding qualified staff...

Thanks for the "Just one post" invitation. Its been a while since I saw posts relating to histotechnology and cytotechnology which are my areas of interest. I hope to frequent the site if more of such posts are included. All the same thank you once again.

I do find this forum a very helpful resource. I am new here and I am looking forward to helping this online community of lab professionals grow.

Hi Cliff, In response to the email reaching out for posts, I decided to log in again. I began in the group 15 years ago when it was Blood Bank Talk. It'd been a while since I logged in so I had to re sign in thanks to your prompt. I am 99% sure I had always used my user name to sign in, not email, but I was not allowed to enter anything that in the field without an "@" . I tried my email addresses unsuccessfully. I was able to gain access by doing a password reset and was then automatically in. I went to edit profile and I don't even see my email address to update as it was changed by our hospital (but I can still receive mail sent to old address as it automatically goes into the new mail) I do appreciate this site, but will admit I'm distracted by pages on the social media platforms where I spend more time. I suspect I'm not alone here.