Patient with bowel issues presented with serious haemoloysis, Hb dropped to below 60g/L. Frank haemolysis apparent but DAT was completely negative, Ab screen/IAT and enzyme IAT panel neg, auto negative, eluate neg vs panel by IAT.
Consultant Haematologist suggested performing T activation studies. Patient was found to be Tk activated, but Tk activation not associated with haemolysis.
I have heard on the grape vine that Tk activation is associated with acquired B phenotype. Patient was group A with anti-B. Current ABO typing reagents do not detect acquired B, so we do not know whether this patient had acquired B.
Hypothetically, could haemolysis occur with acquired B? Could the patient's naturally occurring anti-B haemolyse the 'acquired B' red cells???