Cecilia Posted March 11, 2019 Share Posted March 11, 2019 Hi: patient is positive for all panel cells and autocontrol.DAT pos for IgG only. Recently transfused and requires units, how to proceed next Thank you Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted March 11, 2019 Share Posted March 11, 2019 This is nasty. Do you know the underlying pathology? Is there a pre-transfusion sample still available from the patient? What is the ethnicity of the patient? What is the ABO group of the patient? Surely you gave give us a few more details than you have given? Previous results? Anything could help. Link to comment Share on other sites More sharing options...
Cecilia Posted March 11, 2019 Author Share Posted March 11, 2019 Hello Malcolm,. O pos 30 yrs old. She has never been pregnant. New DX of uterine cancer, required 4 units after surgery 3 weeks ago in another hospital, no records available. Dr put off transfusion for today but wants blood ready ASAP. Panel done in gel 2+ all cells except one R2R2 that was negative. Auto is 3+. DAT is 3+ IgG. Thanks Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted March 12, 2019 Share Posted March 12, 2019 I take it that there was more than one example of R2R2 used, as you say "one R2R2 that was negative", which is a pity, otherwise I would have been thinking in terms of an anti-e (or, possibly, anti-hrB, depending upon the lady's ethnicity. It still could be, but perhaps there is another specificity there too. The real problem here is the transfusion three weeks ago. This could lead to alloimmunisation, but, according to Petz and Garratty (and I certainly wouldn't argue with them!), it could easily be exacerbating a low-grade, almost undetectable auto-antibody, and anti-e is a very common specificity found as an auto-antibody, although often as a mimicking specificity. This, together with the lady's underlying pathology, suggests to me that it is an auto-anti-e, BUT I HAVE TO STRESS THAT THIS IS A GUESS. In a case like this,a sample really should be sent to a Reference Laboratory. TreeMoss, ANORRIS and Arno 3 Link to comment Share on other sites More sharing options...
TreeMoss Posted March 13, 2019 Share Posted March 13, 2019 On 3/12/2019 at 4:09 AM, Malcolm Needs said: In a case like this,a sample really should be sent to a Reference Laboratory. That is definitely what we do here. We do not have what we would need for an autoabsorption, and our ARC Reference Lab folks serve us well. ANORRIS 1 Link to comment Share on other sites More sharing options...
SMILLER Posted March 14, 2019 Share Posted March 14, 2019 Drugs? Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted March 14, 2019 Share Posted March 14, 2019 Could be, but, in this case it just doesn't "feel" like drug associated. Link to comment Share on other sites More sharing options...
Cecilia Posted March 14, 2019 Author Share Posted March 14, 2019 Thank you all. We have sent to reference lab and waiting for results .patient is doing well Link to comment Share on other sites More sharing options...
Recommended Posts
Create an account or sign in to comment
You need to be a member in order to leave a comment
Create an account
Sign up for a new account in our community. It's easy!
Register a new accountSign in
Already have an account? Sign in here.
Sign In Now