Welcome Bot Posted June 20, 2020 Share Posted June 20, 2020 Hello fletob, Welcome to PathLabTalk. Please feel free to browse around and get to know the others. If you have any questions please don't hesitate to ask. fletob joined on the 06/20/2020. View Member Link to comment Share on other sites More sharing options...
fletob Posted June 20, 2020 Share Posted June 20, 2020 Posted 1 minute ago Help make sense of possibilities and if this is something to be of concern or not or if it could be a false positive: first pregnancy due in August - no previous miscarriages no blood transfusions etc. 2011 college class - did a lab and blood type was A+ (could have easily messed this up) feb 2020 pregnancy appt tested A- and negative for antibodies (13 weeks pregnant) June 2020 pregnancy appt tested A- but positive for “Passive anti D” antibodies (29 weeks pregnant) NOTE: doctors are super concerned and sending for ultrasound. Lab just assumed the result was expected because RHOGAM was given the same day BUT rhogam was given AFTER the blood was drawn So WAS NOT A FACTOR. Docs were waiting on a report of the titre but the lab never ran it. They said that because they already gave rhogam they couldn’t accurately get a titre now if the redid the blood draw. Rhogam was never given before in patients life. No history of any trauma, no accidents... everyone is confused. Please help make sense of this, it is driving me crazy. Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted June 20, 2020 Share Posted June 20, 2020 Firstly, welcome fletob. There are several explanations for this, and the first one is that the blood drawn in 2011 was either from another student, or that the test was less than accurate (were the samples accurately labelled, and were strict positive and negative controls used). After that, if the antibody screen was negative at 13 weeks of gestation, but positive at 29 weeks of gestation, then either the anti-D has arisen due purely to passive injection, or an extremely unusual case of anti-D sensitisation in a first pregnancy, and an even more unusual case of a serious case of allo-anti-D in a first pregnancy. I would ask if the doctor who is "super concerned" is a doctor who is experienced in this line of work? By that, I mean, would other gynaecologists/obstetricians, foetal medicine doctors and/or blood transfusion/blood group serology doctors be as "super concerned"? Okay, I understand that it is a mystery, but until you get the results back from all the other tests (ultrasound AND titre - it would not be the first time someone has received their anti-D immunoglobulin BEFORE their "pre-anti-D immunoglobulin" was given) I think that worrying is a bit premature. Anyway, keep us informed, but, meantime, to repeat, welcome. Link to comment Share on other sites More sharing options...
fletob Posted June 20, 2020 Share Posted June 20, 2020 Thanks for the response! I read about weak d so didn’t know if that could be a cause for the result or even a possibility. They are considering it a rare occurrence. The rhogam was 100% given after the blood draw and had never been given to me before. This doctor seems very experienced but I will see at the ultrasound if mfm is also as concerned. Can they do an accurate titre now since the rhogam has since been given? It was 100% given right AFTER the blood draw? What I also find interesting is with how rare this is to begin with even for a second or third pregnancy was that the doctor mentioned having 2 other patients with the same issue of already being rh sensitized prior to receiving Rhogam. Could the lab have just messed the results up? Link to comment Share on other sites More sharing options...
fletob Posted June 20, 2020 Share Posted June 20, 2020 Now there is another note in my chart referring to Antibody S? What is the difference between Antibody S and Antibody D? Is one worse than the other? Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted June 21, 2020 Share Posted June 21, 2020 (edited) Anti-D is an antibody directed against the D antigen of the Rh Blood Group System. Anti-S is an antibody directed against the S antigen of the MNS Blood Group System. Anti-D has often caused severe haemolytic disease of the foetus and newborn. Anti-S, on the other hand, although it has caused severe haemolytic disease of the foetus and newborn, it only does so in VERY rare cases. These days, with the vast improvement in foetal medicine, neither antibody should cause real problems to either the mother or the baby. Antibodies to antigens other than ABO in the circulation are not that rare. About 3% of patients in hospitals have antibodies, although the number falls in donors. I am not going to say that blood transfusion laboratories do not make mistakes (everybody makes mistakes), but it is still highly unusual, and to assume that this situation is due to a laboratory error, before all other avenues have been explored, is highly insulting to the intelligence and professionalism of the people who work in these laboratories. Edited June 21, 2020 by Malcolm Needs Spelling error. Ward_X 1 Link to comment Share on other sites More sharing options...
fletob Posted June 21, 2020 Share Posted June 21, 2020 Thanks! That makes me feel better. Of course when I google everything about severe brain damage and death comes up so it is terrifying. I definitely did not mean to insult all lab professionals. I just know a lab professional in the area where I live (super rural USA) who frequently complains about his coworkers messing up their work and he has to fix it. I was also questioning maybe it was a mixup just because it didn’t make sense for it to happen at this time and it looked like they didn’t read that the shot was given after, not before, given that was what they attributed it to in the note on my chart. Along with the doctor saying they should have done a titre but never did. Things just weren’t adding up overall. I know there’s always at least that “one” person in any profession, haha, at least in my field there is. If I were generalizing to all lab techs I wouldn’t be reaching out to them on a message board. Haha I had heard of rh negative and positive. But I have never heard of MNS before. What is this blood group responsible for? I have no idea if it is relevant or not but I have had past positive ANA tests, which I just attributed to my body being weird because of having Ehlers Danlos Syndrome since things like early onset arthritis are common with that. (Actually my joints have been 10x better while being pregnant ) Malcolm Needs 1 Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted June 21, 2020 Share Posted June 21, 2020 Thanks for that. The antigens of the MNS Blood Group System (there are now 39 different systems, but well over 200 different antigens), of which there are actually 49 antigens within this single system, are largely receptors for complement, bacteria and viruses , such as Eschericia coli and influenza A and B virus, but the carrier molecule upon which S is expressed is also a ligand for the malarial parasite Plasmodium falcipaum. Link to comment Share on other sites More sharing options...
galvania Posted June 27, 2020 Share Posted June 27, 2020 Sorry all, I replied on the other channel before reading all the above. ……... Link to comment Share on other sites More sharing options...
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