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John Eggington

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Posts posted by John Eggington

  1. I'd do an auto against ficin treated patients cells. A positive results could be due due auto-anti-D but I think it would more likely represent an 'enzyme auto', as there's a reasonable chance the anti-D is 'allo'. Either interpretation would be 'OK' as both mean 'select' D- blood for xmatch, which is probably what you'd do anyway. A negative result would put you back in the 'what is it?' situation.

  2. My thoughts are; if the unts given 4 weeks ago were 'random' Rh phenotypes, then all will (almost certainly) have been e positive (and have a good chance of being f positive, and slightly less so of being C positive). The circulating residue would give phenotyping results that are difficult to interpret, promote an (allo) immune response, and give ambiguous auto/DAT results (patricularly if the technique of auto and DAT vary a little). So I'm till clutching at straws for my 'boring' answer!

  3. How about something more boring;

    1) Rh/JK typing results not valid because of recent transfusion

    2) Patient is R2R2, not R1R2

    3) Antibodies detecetd (anti-f +/- anti-e +/- anti-C) are weak alloantibodies

    4) Auto/DAT results are 'inconclusive' because only the residual cells fron 4 weeks ago have antibody coating them

    5) Delayed-type 'transfusion reaction' is occuring (but not clinically significant)

  4. I was just making a general point, that this particular example highlighted - that there are other things to think about. I know some antibodies, that you'd expect to be detected by 'enzymes' (the cited anti-E, for example), may not react as you'd like, but they're not common enough to make us doubt our 'enzyme' panels, I hope (which is why they get published, I guess - who wants to read about ant-E that was detected by 'enzymes'!). Hooves and zebras, as is oft quoted here...

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