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@Neil Blumberg yes - we are familiar with the "Ogata Phenomenon" we have seen it before and those have easily been resolved by washing with PBS rather than the "working wash" for the EluKit. This particular patient is not resolved - making it a bit of a mystery outlier.

I do not know if Malcolm's case was published (I did not find it?) but this kind of auto anti-K mimicking an allo antibody is well described in this paper issued back in 1982 Autoanti-K antibody mimicking an alloantibody, Transfusion Jul-Aug 1982;22(4):329-32, E. Viggiano et al. This anti-K was adsorbed onto and eluted from both K pos. and K neg. cells.

The observation that antigen negative cells can yield an eluate with an antibody for an antigen not present has been known for more than half a century I believe. It's often referred to as the Matuhasi-Ogata phenomenon, first reported in the 1950s and 1960s. My mentor, Joe Bove and Patrick Mollison wrote about this a bit later in the 1970s based upon work Bove did during a sabbatical in London. Needless to say, I heard about this often as a resident physician under Bove's supervision :). Brings back memories.... Immunology,1973,25,793. Non-specificBindingofIgGtoAntibody-coated RedCells (The'Matuhasi-OgataPhenomenon') J.R.BOVE,*A.M.HOLBURNANDP.L.MOLLISON MRCExperimentalHaematologyUnit, StMary'sHospitalMedicalSchool,LondonW21PG Summary.Severalobservershavereportedthatredcellscoatedwithaspecific blood-groupantibodymaytakeupasecondblood-groupantibodynon-specifically, aneffectknownasthe'Matuhasi-Ogataphenomenon'.Inthepresentwork, thiseffectwasinvestigatedusingeither'25I-labelledantibodiesofvarious specificitiesora1311-labelledpreparationofIgGlackingrelevantantibodies.In confirmationofmuchpreviouswork,itwasfoundthatredcellstookupappreciableamountsofIgGnon-specifically;however,thisuptakewasnotincreased bypreviouscoatingoftheredcellswithspecificantibody.WhentheIgGtakenup non-specificallyincludedablood-groupantibodyinrelativelyhighconcentration, aneluatesubsequentlypreparedfromtheredcellscontainedsufficientoftheantibodytobedetectable.Thus,thefindingofunexpectedantibodiesineluatesmay beduetonon-specificuptakeofIgGratherthantoadherenceofantibodiesto antigen-antibodycomplexes.