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Bb_in_the_rain

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Everything posted by Bb_in_the_rain

  1. I have heard a couple of different clones coming from Seattle Hospitals (Hu5F9-G4 and ALX148). Watch out for the clone numbers when you work on patients on anti-CD47. It might make a big difference whether or not you can use Immucor anti-IgG to rule out your underlying alloantibodies.
  2. I am sorry I apologize for failing to realize that there may be more than one blood group recombinant proteins available for use in immunohematology. We may be talking about different recombinant proteins. The protein that I was thinking about is soluable CR1 recombinant protein (Mould JM, et al, Neutralization of Knops system antibodies using soluable complement receptor 1), which may be different from that of recombinant glycophorin protein by Schawalder A et al. Therefore, when I made up the result that "rRBG-treated plasma was positive", I meant to exclude antibodies to Knops and Ch/Rg blood group proteins. I also failed to mention that the suspect would be anti-EnaFS (but not Anti EnaFR or anti-EnaTS, which I almost have forgotten about since I have not seen those before). In this case, I suppose we can throw in anti-Pr to the mix of possibilities (if the patient's cell is glycophroin-deficient, with autocontrol negative, long shot??). Thank you very much for an opportunity for further learning. Awesome as always!!!
  3. For those of who works in transfusion service laboratory and would like to learn more reference cases, I can post some mock-up cases here. If you would like me to do it, please hit the "heart" button on this post. If enough folks want to practice case studies on reference lab cases, I can post mock-up cases here weekly or so..
  4. Rh negative is more prevalent in Europe than US that European Blood Centers can afford to permanently defer donors with anti-D without hurting Rh neg supply?
  5. Could the patient be on some sort of suppressant drug or steroid during the time when anti-D became negative? What is the diagnostics?
  6. Lets say the antibody is not inhibited by Pooled plasma or rRCP. What would be next?
  7. My thought when I made up this case was missing/weak glycophorins. So anti-Ena would be one of them. What else are the possibilities?
  8. CD47 is not effected by ficin treatment. There are currently several different clones in clinical trial. So there are so many names!! Fy3 and U antigens are not destroyed by ficin as well, even though Fya, Fyb, S and s are destroyed by ficin.
  9. Woops!! I totally messed this one up! I meant to say they are positive!!
  10. Hello, Hematologists! I am a blood banker who is trying to understand the flow cytometry to estimate the proportion of chimerism in hematopoietic transplant patients. In the report different CD markers for erythroid precusor cells were mentioned. As I understood, some CD markers were specific for red cell line and some were not specific. Is there any chart or tables of CD markers found in erythroid precusor cells that I can study from. Or any references that I can read up on it?
  11. Hello, I am wondering if access to Vox Sanguinis is only for ISBT members. Is there a way to read the magazine without having to join the ISBT?
  12. Very well done!! You were right that there was something corresponding to an enzyme-sensitive antigen or antigens. Now here is more information in order for you to sort this out. In your antibody panel, Fy(a-b+) S-s+ cell was negative Fy(a+b-) S-s+ cell was negative Fy(a-b+) S+s- cell was negative Fy(a+b-) S+s- cell was negative . What do you think now?
  13. Lets say it is Monday morning. Your night shift tech was in a very good mood, finished all the QC and patient works. Also, there was no more patient work up coming in on Morning morning rush, it is an unusually quiet morning. So, you got all the time you need to solve that case! Also lets say your antibody panel vendor happened to be so generous that they will provide all kinds of cells that you want.
  14. Alright, since most transfusion service agreed to send it off the reference lab, maybe reference folks can shed some light on this case?
  15. Yes. we see so much anti-Jka in this lab (something must be in the water here). Some reacted only by solid phase, some only by enzyme-IAT but not with peg-IAT method. We type the cells and they were Jk(a-) half the time, in which case we recommended transfusion Jk(a-) blood. Has anybody encountered this and look into this?
  16. What about genomic D typing this patient to see if he is Weak D type1,2 or 3? If he is, transfuse R1R1 units?
  17. Lets do a muck case study just for fun. Here we go. Background- 31 year old Hispanic Male was admitted to hospital with GI bleed. Patient blood type is O Pos, C+E-c-e+K-S-s+Fy(a-b+)Jk(a+b-). Antibody screen showed all 3 cells positive (2+) and autocontrol was negative All 18 cells tested in antibody panel showed positive (2+) reaction, including C+E-c-e+K-S-s+Fy(a-b+)Jk(a+b-) cells. Ficin-treated panel cells were all negative and DTT-treated panel cells were all positive. What would you do next? ** I am trying to tease some brains from transfusion services. If reference lab folks are reading this, please do not give away the answer**
  18. Sounds like a good plan, if you see "top line" in your gel. I would include an autocontrol when I set up A, B, Cord cells and extend incubation time till autocontrol comes up positive. (to really make sure that I am not looking at an allo-antibody) Hope you get your "rule-outs" in tube saline tube method! Good luck!
  19. We have had some colds, non-reactive in solid phase but reactive in tube. In above case, I would approach it by performing antibody identification by tube method. (since I am conservative)
  20. Since it is widely publicized to consider Weak D Type 1,2 or 3 as D+, I think it will be a good idea to document anti-D production in Weak D type 1,2 or 3; at least as an abstract to professional organization if not as a full case report. Each case may count as "exception" and if there were too many exceptions, the hypothesis (or proven theory) may be challenged. That is just "my feeling" anyways. I can be very wrong since I am not an expert .
  21. Since we have capability for molecular tests in this lab, we would refer to molecular testing for the following populations, (if D typing is <2+) 2) Women with child-bearing potentials 3) Potential transplant recipients If you do not have molecular testing capability, I suppose you can call them D- (to be conservative) For the following population of patients, we interpret any positive reaction as D+ (if the DAT is negative) 1) Males (<18 year old) (exception is our local Children's Hospital) 2) Female with no child bearing potential 3) blood or organ donors
  22. A powerpoint slide from 2018 AABB case presentation by Woo JS, et al. included a page of reported anti-D cases (see attached picture) So there would be 7 total cases of anti-D production in Weak D type 1,2, and 3, including the case that was presented. The authors also have footnote that some of these anti-D has both auto- and allo- antibody characteristics.
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