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Posts posted by galvania
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so very sad. A great loss to the profession
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And a bit more 'way out' - has he received any plasma for Covid that might have contained the anti-D?
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Did he not receive any blood products then in 2016?
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On 8/25/2021 at 8:08 PM, TreeMoss said:
This amount would have been indicated from the results of the Kleihauer-Betke stain for fetal hemoglobin.
Or was the K_B positive because mum had high levels of HbF and therefore none of the injected anti-D 'used up'?......
Butlermom - where are you??????
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Also how strong is her anti-D at 6 months and by what technique?
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On 8/9/2021 at 11:13 PM, butlermom said:
6 months ago we had an Rh negative OB patient who delivered an Rh positive infant, and subsequently required 4 doses of RhoGAM. I
Why did she need 4 doses ?
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..........and on the result of the reagent control you put up with it and what is wrong with the patient, if it's a man or a woman,and how old................and why you were doing the test in the first place
- David Saikin and Ensis01
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I would just be a bit suspicious if say there was a + reaction with A1 cells and 4+ with B cells in an apparent group O - or vice versa; or very weak reactions in a young healthy adult.....a bit of common sense required, that's all
- David Saikin, Yanxia, Marilyn Plett and 1 other
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or mum is a surrogate
or baby is the result of an ivf with external donors
- Malcolm Needs, Yanxia, AMcCord and 2 others
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to be fair techniques in the early 80s were not what they are today, neither for blood grouping nor for antibody screening/identification. Methods were not standardised. The number of drops of serum (almost always serum) to the amount of red cells could vary from 2:1 to 8:1. The concentration of the red cells could be anything from about 2% to almost 10% - and often pooled. And pooling was one of the main reason for checking under the microscope. Incubation time varied too - often depending on the length of your coffee break or lunch break. LISS was in its infancy. Washing was done by hand or with a 'Coombs washer' - 3 or 4 washes, with or without albumin. So perhaps not surprising that people were not too confident in their visual results. Much less knowledge then too about what was and what was not clinically significant. (I can remember when we treated cold anti-A1 as clinically significant)
Thankfully since those dark ages things have improved massively - but sometimes some of the old habits stick - like using a microscope to read apparently negative results. The practice lives on (in some places) but the reasons for that practice died out long ago
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true. Should have read that more carefully.
Well the answer is still - yes and no. If you are using monoclonal reagents, and assuming the anti-D has the same formula as the other reagents (barring the actual antibody obviously) then most results will have at least one negative well that can serve as a control in any case. You could just then put up a neg control on the AB+ results. But the majority of cards/cassettes do have a control on them anyway. If there's only anti-A-B-D, that's only supposed to check a group that is known i.e. has already had at least one full group with a control. But there too - only a problem if AB+. And if you are using an Rh pheno card, the control well on the grouping card is valid provided that the formula for all reagents is the same
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well yes and no. It would depend what the test was. The typical test not offering controls would be an antibody screen. As most of these are negative or positive with only some of the cells, this acts as its own control. Where you would need to perform a 'negative' control is if all screening cells are positive. This would be done by carrying out an auto-control with the panel. If that is positive too, however, you still won't know, in the absence of any other information, whether the patient has a true auto-antibody or whether the patient is reacting because of the potentiator in the AHG / diluent.
For antigen testing, a must however, especially if tested in an IAT or with enzymes
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of course it could just simply be that the hospital lab made an error grouping it as a false positive. As this is a question designed for new students, I doubt whether the level of scientific understanding required is very high at this stage. It would depend what theory the students had done up until the point that the question was set
- Malcolm Needs and mrmic
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Three to four a week out of how many tests?
Where are you getting your cells from? Is the reaction strength the same with all cells?
Are you working manually or with an automat?
Have you noticed a correlation with these patients' ABO groups?
Also do you have any lookback as to whether the babies of these women were jaundiced or anaemic post delivery? Or were they OK?
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Do keep us updated. I am sure we are all looking forward to news of a healthy baby
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Can I just point out here that no one serological test, or even combination of tests will detect all weak / variant Ds . And that includes women who test D+ but actually have a partial D and may make anti-D antibodies. It is SO important to know your reagents, and know what your anti-D reagents will and will not detect
- Malcolm Needs, TreeMoss, hunb and 4 others
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Sorry all, I replied on the other channel before reading all the above. ……...
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First of all, please do not worry. IF you do have anti-D antibodies, and they are real antibodies, this is only one of a number of tests that the doctors will do during your pregnancy to make sure everything is going OK with your baby.
What they should do is recheck your blood for anti-D levels now and again in about 4 weeks' time to see if there is any change. It will show anti-D because of the Rhogam, but the important thing is to see whether the level increases significantly over time. Also, even now, if it is very high (VERY unlikely) then that would indicate it's real anti-D as opposed to the Rhogam.
Ultrasound is a good idea. It is usually done anyway during pregnancy, but it will also show if something is happening that they need to react to.
- Malcolm Needs and SbbPerson
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1. did you think to do a DAT on the posttransfusion sample to see if the antibody was all 'stuck' on to the transfused red cells?
2. What method did you use to K-type the units of blood? did it involve an IAT? If so was the positive result a false positive because the unit had a positive DAT?
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sorry for the late reply.
What I meant is that one tends to put up a batch of antibody screens. In the time taken to put up say 12 screens the cells can cool down enough for a cold anti-M in the plasma to latch on. On the other hand, panels tend to go up one at a time (1 patient at a time) so cells have less chance of cooling down. (Always assuming the screening cells and the pane are from the same manufacturer and being tested in the same method)
- John C. Staley and SbbPerson
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Positive crossmatch
in Case Studies
Posted
How are you doing your crossmatch? This could, as Arno said above, be an anti-buffer reaction - or it could be a cold antibody that's got enough time to stick on to the red cells before they get to 37°C. Can't be an antibody against a low-frequency antigen - not with 4/4 being positive. I would also double check that the blood bags really are Jka- and of the correct ABO group. You haven't answered the question about the patient's blood group.........