Hi everyone We had a case of a 30 year old female with AIHA and a Hb of 5g/dl. Her EDTA plasma reacted with all screening cells (CAT-IAT) and Identification cells (CAT- IAT and Enzyme). The reactions were all of the same strength; 3+ in the IAT and 4 + in enzyme. The auto control in IAT was also positive. We repeated the screen using the tube technique and monospecific coombs IgG. The screen was positive with all the cells. The DAT with polyspecific AHG was strong positive. Reswults with monospecific AHG were as follows (anti-IgG strong pos; anti C3d weak Pos). The patient was never transfused, blood group A RhD Positive, K negative, and ccDEe phenotype. We performed an warm allo adsorption using R1R1, R2R2 and rr cells. the following results were obtained on the adsorbed plasma. R2R2 - no antibodies detected; R1R1 - anti-E identified; rr - both anti-D and anti-E identified. I have never encountered auto anti-D and auto anti-E together. I was wondering if anyone has had a similar case or could share some ideas and information:o Thanks Jesmond