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Rhona24

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About Rhona24

  • Birthday 08/18/1962

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  1. Yes it was done using an ABO genotyping kit. We have run out of sample now but have requested further samples to try and reproduce the results as we only had enough plasma to do one test v AB CCDee red cells.
  2. We have an obstetric patient who is group AB CCDee, DAT neg and has an anti-c.The anti-c was reactive in the reverse group of the ABO so we used A1 and B CCDee red cells to confirm the ABO and were surprised to see that the B cells were strongly positive. We have genotyped the patient and this confirmed that the patient is AB. We then investigated the sample for the presence of cold reacting antibodies however the panel was negative but the B cells and auto were. positive(RT tube). We tested with a further 2 B CCDee and 1AB CCDee. The two group Bs were positive but the AB was negatve.(Rt tube) It looked like an auto ant-B bit this doesn,t explain why the AB was negative but the auto was positive. Just thought I would ask if anyone has seen anything like this before or if anyone had an explanation?
  3. We have a 35 year old obstetric patient (CCDee, weakly pos DAT (IgG) ) who is 11 weeks pregnant with an apparent auto anti-D. She has had 2 previous misscarriages. After the second miscarraige she had a warm free auto antibody reacting with all cells but when titred out showed anti-D specificity. Anti-D was eluted from her red cells. Has anyone else encountered this?
  4. Yes. We tested it against 2 Lea-b- and both were positive. Her auto was also negative. We have also asked the referring hospital to check the transfusion history with the patient and her parents and we will probably still test her against appropriate high incidence antigen negative cells.
  5. We received a sample from a 13 year old girl who presented at her GP with lethargy and dizziness. Her Hb was found to be 7.5 with a slightly raised bilirubin. She has no history of previous transfusion or medical condition. The results of the testing were as follows.Group B CcDee, DAT negative. Positive 2+/3+ with all panel cells by Ortho/Diamed IAT. Positive 4+ with all enzyme treated red cells using Ortho CAT. 2+ positive using LISS tube IAT. 4°C and RT screen negative. Extended typing K- k+ ,Fya-b+, Jka+b+,Lea-b-, S-s+, M+N+, P1+ Lua-. Does anyone have any explanation for these results in view of the fact that they are fairly certain she has never been transfused?
  6. I am delivering a case study about anti-G in an obstetric patient. The baby in this case was Ccdee but I wondered whether anyone had ever seen an obstetric patient produce an anti-G but not an anti-D when the baby was D+ ? or is the administration of prophyltactic anti-D to women who have a anti-G or anti-C+G only to cover a theoretical risk?
  7. Thanks for all your comments. We have already discussed this patient with the medical staff and will continue to monitor the antibody levels throughout her pregnancy.
  8. We have an obstetric patient who was given 1500 iu of prophylactic anti-D at 28 weeks. 3 days later a sample was tested and found to have a titre of 1/256 v R1R1 red cells and a quantification of 7.6 iu/ml.The referring hospital had no record of an antibody screen result immediately prior to the administration of the prophylaxis though they did have a record of a negative antibody screen in April. The results of the current tests would appear to be a little high if they were due to the prophylaxis, however I have found a report saying that ocassionally levels of 6 iu/ml of anti-D have been detected following standard anti-D prophylaxis. I wondered if anyone had any thoughts about whether our results could be due to the prophylaxis? We will continue test her regularly so that we can monitor the anti-D levels.
  9. Thanks for your replies. We need to do Anti-G investigation as the BCSH guidelines recommend it for pregnant women with apparent antiC+D specificity. At present we use papainised r'r and R2R2 cells to adsorb the plasma and perform elutions on the adsorption cells. Malcolm- do you use papainised cells for your adsorptions and do you use any controls?
  10. Does anyone have a validated method for the investigation of Anti-G?
  11. We recently took part in an evaluation which involved doing antibody screens and ID panels with trial and routine cells using both automated and manual techniques. We have access to both Ortho and Diamed technologies so used both systems in our evaluation. The samples used were all red cell antibody screen negative plasma samples which had been frozen and thawed. The samples were allowed to come to room temperature and spun before use. They were put though both analysers with no problems, however when we carried out the manual testing a large number of wells showed apparent dual population reactions. We then preheated the cells and plasma and repeated the tests. There were less dual population reactions but they did not disappear completely. Has anyone else seen this and does anyone know of an explanation for this?
  12. I am not familiar with the terminology PANTS either. I am guessing it must be something to do with Anti-A and Anti-B titres or donor accreditation.
  13. The Anti-D level rose steeply in the last trimester of her pregnancy. I know from experience that these babies are not usually as severely affected by HDN so I wasn't surprised that he did not need an exchange transfusion. I agree that the delivery sample was probably a mixture of of the baby's own cells and the transfused cells and that the D antigen is blocked by the maternal antibody but what I don't understand is why they are typing as ccde with no mixed field reactions with the A/C or A/E. I am assuming that if the father is D+ he is likely to be either C+,E+ or both. The mother went into premature labour, but I think from memory she was about 36 weeks. A sample would only be sent for foetal genotyping on request by the referring hospital.
  14. The Anti-D level rose steeply in the last trimester of her pregnancy. I know from experience that these babies are not usually as severely affected by HDN so I wasn't surprised that he did not need an exchange transfusion. I agree that the delivery sample was probably a mixture of of the baby's own cells and the transfused cells and that the D antigen is blocked by the maternal antibody but what I don't understand is why they are typing as ccde with no mixed field reactions with the A/C or A/E. I am assuming that if the father is D+ he is likely to be either C+,E+ or both. The mother went into premature labour, but I think from memory she was about 36 weeks. A sample would only be sent for foetal genotyping on request by the referring hospital.
  15. We did think that it was possible that we were typing the transfused cells so we contacted the hospital to ask what the baby's Hb and bilirubin levels were. The baby had a Hb at delivery of 16 and a bilirubin of 96. A few days later the Hb had dropped to 11.7 and the bilirubin risen to 188. The baby was given a top up transfusion 20 days after delivery. I am struggling to think of a logical explanantion for these test results as it looks as if the baby's own cells were not all destroyed by the maternal Anti-D We have asked for a repeat dample at a future date to repeat out tests.
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