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Anti-P1 in an eluate?


pbaker
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Has anyone ever seen Anti-P1 eluted from RBCs? 

We have a patient with a negative antibody screen.  The physician ordered a DAT because the hemoglobin has been dropping even with transfusion.  The DAT was positive due to IgG only.  Since the patient was recently transfused, an elution was performed.  When the eluate was tested, the pattern fits Anti-P1, with all other clinically significant antibodies ruled out.  Can it be???

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Very interesting. May I ask what assay/test is being used to detect the antibody ? Tube (with or without additive), gel, solid phase ?

And, may I presume that the anti-P1 is believed to be the the cause of "the hemoglobin has been dropping even with transfusion." ?

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29 minutes ago, exlimey said:

Very interesting. May I ask what assay/test is being used to detect the antibody ? Tube (with or without additive), gel, solid phase ?

And, may I presume that the anti-P1 is believed to be the the cause of "the hemoglobin has been dropping even with transfusion." ?

On the back of that, can I ask what is the ethnicity and underlying pathology of the patient please?  If there is no bleeding point, has the Hb dropped below the level it was before transfusion?

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Patient is caucasian with cirrhosis, sepsis, ARF, among other things.  Not a healthy person.

The patient hgb was stable in the 7s until a big drop to the 5s.  Even with transfusion, the hgb was having a hard time getting up to the 7 again.  So the doc ordered a DAT.  I really don't believe the Anti-P1 has anything to do with his hemoglobin issues.

We use the Elu-Kit to for the elution and perform tube testing with no additive.

Malcolm, thank you for the powerpoint, but I can't seem to open it.  

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