Malcolm Needs
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Welcome NikkiHCLS.
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Welcome hmh.
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Welcome Ranju.
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Welcome Shmoops.
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As Rh grouping reagents are, these days, almost, if not absolutely, monoclonal IgM antibodies, and therefore, not affected by a positive DAT, one wonders under what situation this would pertain, unless the mother was D Negative and the antibody causing the baby's DAT was positive. If this were so, why would you not be able to use the results of the IgM monoclonal reagents? If, for some reason you could not (the reason why escapes me), you could treat the red cells with chloroquine (although this , in itself, weakens the Rh antigen expression), or, of course, you could give anti-D immunoglobulin anyway, and assume that the baby is D Positive, with no evidence whatsoever, and expose the mother to 1) a human-derived antibody, which may be carrying a virus that has yet to be recognised, that they almost certainly do not require, and 2) a human-derived antibody that may cause a severe reaction due to, for example, anti-IgA, I really WOULD advise that you rely on the results you get with IgM grouping reagents, and stop worrying about the tiny chances that there would be clinical sequelae, and I (seriously) would advise the likes of the FDA do the same!
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What would be really helpful, and is quite simple, is to treat the plasma with 0.01M DTT (or ZZAP come to that), which will denature IgM molecules by breaking the J-chains. This will show if the antibody is IgM or not. Do not forget that some IgG antibodies can cause agglutination in the "cold" and the "warm", with no potentiating agents being present, so it is worth knowing, from the word "Go", with what you are dealing.
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Welcome 1 freshginger.
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Welcome Jalene.
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Welcome Kathleen B.
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Indeed not, but it would be detected in many cases.
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It wouldn't be missing those specificities that would worry me so much as missing an anti-Vel. Such antibodies are extremely rare. Such antibodies are also extremely clinically significant.
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RHIG stored at room temperature for hours
Malcolm Needs replied to simret's topic in Transfusion Services
Fair comment John, not fatal septicaemia, just fatal cellulitis! My point was though, that it is just not worth taking the risk. -
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Malcolm Needs reacted to a post in a topic:
At my hospital we manually enter Type and Screen results....
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If you go to the Library Section of this site, Educational Material, second page Allo-Immune Haemolytic Disease of the Fetus and Newborn (HDF / HDN), and look at slides 45 to 60, you will see photographs of the continuous flow analysers sued within the NHSBT to perform quantification of anti-D and anti-c. These photographs are of one of our older machines, as it allows you to see what is going on, whereas the newer machines are enclosed in the ubiquitous "black box", so you wouldn't be able to see anything. Attached is a Word document that, I hope, explains the photographs. Alloimmune Haemolytic Anaemia and Disease of the Foetus.doc
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Welcome LAB216.
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antibody identification art or science
Malcolm Needs replied to sherif's topic in Transfusion Services
I've put this right since BankerGirl!
