Bbank90 Posted March 10, 2020 Share Posted March 10, 2020 Advice on how to proceed if possible. We were given a teaching case as follows: Patient has HX of WAA, with every antibody except for C, and E according to HX. DAT and Auto control negative, screen positive at IS and PEG-IAT. Not enough cells for autoadsorption-would you proceed with an alloadsorption or ? Thanks for any direction. Yanxia 1 Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted March 10, 2020 Share Posted March 10, 2020 Alloasorption. In fact, having worked in Reference Laboratories for most of my life, it was VERY unusual for the patient either to have NOT have a transfusion within the previous three months - meaning that they were not a candidate for auto-adsorptions - or their haematocrit is so low that there are too few autologous red cells to perform an auto-adsorption in the first place (usually because they were sent to us because they needed a transfusion in the first place!). e specificity, Ward_X and Ensis01 3 Link to comment Share on other sites More sharing options...
Yanxia Posted March 11, 2020 Share Posted March 11, 2020 The DAT and Auto control negative, do we need to do auto-adsorption? Link to comment Share on other sites More sharing options...
Bbank90 Posted March 11, 2020 Author Share Posted March 11, 2020 28 minutes ago, yan xia said: The DAT and Auto control negative, do we need to do auto-adsorption? Taking this case further...an alloadsorption was done, only one cell was positive when redoing the screen. C and E were then ruled out with a select cell. Crossmatch results were as follows: IS compatible, Peg- IAT incompatible, Peg-IAT with adsorbed plasma was compatible. In theory this faculty will only accept usage of PEG when crossmatching for them. Getting mixed messages regarding the approach taken. I’ve seen cases similar and not sure what should’ve been done differently? Link to comment Share on other sites More sharing options...
Yanxia Posted March 11, 2020 Share Posted March 11, 2020 (edited) That was new to me, is it because the auto-cells are antigen-depressed by the autoantibodies or some other reasons? Edited March 11, 2020 by yan xia typo Link to comment Share on other sites More sharing options...
e specificity Posted March 18, 2020 Share Posted March 18, 2020 if the DAT and auto control are both negative, what are you adsorbing out? An antibody to a high freq antigen? A cold? This would need additional work/perspective. A history of WAA doesn't mean it's a WAA forever. Does the patient have a history of anti-C and anti-E or everything else? Everything but Rh antibodies seems unusual to me. Malcolm Needs, Yanxia and David Saikin 3 Link to comment Share on other sites More sharing options...
David Saikin Posted March 18, 2020 Share Posted March 18, 2020 On 03/10/2020 at 8:49 PM, Bbank90 said: Taking this case further...an alloadsorption was done, only one cell was positive when redoing the screen. C and E were then ruled out with a select cell. If you have done the alloabsorption, do you not elute and test the absorbed abs? I find it hard to believe that a patient would be sensitized to all the ags except C and E. (The most abs I've ever encountered were 10). Yanxia 1 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