Michelle R

Interesting update. Received a very small amount of additional sample and performed a manual GEL (BioRad) crossmatch and it was compatible. Decided to try a 3% 3 cell screen (Immucor) converted to 1% for GEL testing and it was also negative. Very different results since we had been seeing pan reactivity in manual GEL previously (about a week ago). Possible preservative antibody that is neutralized (?) or non reactive in LISS tube? Hoping for more sample to perform repeat testing, maybe whatever it was has gone below detectable limits?

Baby is doing very well. Clinically stable per providers. Hct stable at 37.5. No need for transfusions at this time. Slight thrombocytopenia at birth but has resolved without intervention. Sepsis ruled out. He needed phototherapy for hyperbilirubinemia for a couple days, but interestingly needed less days of light therapy than what is "normal" for preemies. We have included our neonatologist team to see if they have any input/insight, but so far nothing of note.

We were thinking an anti-I initially as well but we didn't find much literature about a premature baby forming an anti-I at birth since it appears to be IgM. We were also wondering about other possible antibodies that would be non-reactive or weaker with cord cells. We requested Immunoglobulin tests and received the results today so I will post them for additional information. IgM is double the upper value for the range?? IgM= 45 mg/dL (range for <1 month old is 4-20 mg/dL); they repeated to confirm IgM= 47 mg/dL IgG= 519 mg/dL (range for <1 month old is 649-1627 mg/dL) IgA= <6 mg/dL (range for <1 month old is 0-0 mg/dL)

Hello Everyone, This is my first time posting, however, I have been creeping on this forum for quite some time and learning a ton! We have a premature baby boy delivered at ~28 weeks that was born at an outside hospital and immediately transferred to us for support. I will list below our test results and the results on mother too (we had blood drawn on mom since the delivering hospital did not have any blood bank testing done). I am curious of any reason for how these results could happen and why LISS testing is the only negative results we are getting. Background - 12 day old (30w3d), Black male - Delivered at outside hospital (OSH) at 28w5d gestation via spontaneous vaginal delivery. - No reason stated for premature delivery. Chorioamnionitis noted on placental pathology report. - Transferred at 0 days of life for prematurity & respiratory insufficiency - No transfusions at OSH or during current admission - TS received on mom 3 days after infant arrived. She had no TS on file at OSH and there was nothing in EPIC indicating history of antibodies Serology Baby - O pos - DAT negative - BioArray complete (C, E, K, Jkb, S negative) - Serology: H positive, M positive, N positive - Initial sample was w+ to 1+ positive with the majority of cells tested in gel (3 cell antibody screen + panel by BioRad) - On subsequent samples, gel became panreactive with scores of 3-4+ - PEG: panreactive with antibody screen (3 cell screen by Immucor) (3-4+) - DTT PEG: positive with pooled screening cells (PSCs) (3+) - Papain gel (BioRad): panreactive selected cell (2-3+) - PEG prewarmed with RT saline washes: positive with pooled screening cells (4+) - Immediate spin (no enhancement): positive with pooled screening cells (3+) - LISS tube: negative with 3 cell antibody screen (Immucor) - Coldscreen: positive at RT/4C with 3 cell antibody screen (Immucor) (4+), w+ with pooled cord cells; non-reactive with autologous cells - 0.01M DTT treated plasma testing invalid for failed saline control Mom - B pos - DAT negative - Negative absc by gel and PEG methods - Gel papain: w+ reactions with 2 HLA+ cells (Biorad, those 2 cells were the only extended typings given on the panel) - Eluate: negative - Coldscreen: weak reactivity @ 4C only with adult cells and autologous cells, non-reactive with cord cells Anyone have any thoughts? We have requested HLA typing (buccal swab) of mom and baby for confidence that the mom is the mom of this baby (since this was a transfer and we did not treat the mother). Thanks in advance for your input!