recently our lab rec'd a specimen for Ab ID on a patient who was known to have an anti-K. This time, however, she also had a strong COLD AGGLUTININ and 2+ coombs ( Igg ++, POLY ++ C3-) So... a REST adsorption was perfomed and it looked to me that she had developed an anti-f to go along w/ her previous anti-K. ( clearcut rxns in 10/16 panel cells,a homozygous c+ cell was NOT reactive) Now, the patient is O pos, C+, E-, c-, e+ , and this gave me pause, but my understanding of the Anti-f antibody is as follows- the epitope is created of the juxtaposition ( cis position) of the c and e antigens, thus Dce/DCE WILL react, while DcE/DCe will NOT. So, my question is whether or not the literature, and collective experience dictates that a patient MUST be negative for BOTH c and e for a patient to develop an anti-f. My understanding tells me my call is reasonable while the senior tech and our technical advisor wish for the report to be changed. ( Call it an anti-c) Either way our recommendation was for IAT crossmatch compatible blood lacking the K and c antigens.