pbaker Posted May 31, 2022 Share Posted May 31, 2022 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??? Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted June 1, 2022 Share Posted June 1, 2022 Yes, and yes, although it is a highly unusual finding. The attached PowerPoint lecture may (or may not!) be of interest, in particular the fourth reference. The P1PK Blood Group System.pptx John C. Staley, Ensis01, AMcCord and 1 other 4 Link to comment Share on other sites More sharing options...
exlimey Posted June 1, 2022 Share Posted June 1, 2022 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." ? Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted June 1, 2022 Share Posted June 1, 2022 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? John C. Staley and exlimey 2 Link to comment Share on other sites More sharing options...
pbaker Posted June 1, 2022 Author Share Posted June 1, 2022 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. exlimey 1 Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted June 1, 2022 Share Posted June 1, 2022 Thanks for that (and see my message sent to you). I was wondering along the lines of hyperhaemolysis, but his underlying pathology suggests that this is unlikely - not impossible, but very, very unlikely. Link to comment Share on other sites More sharing options...
exlimey Posted June 1, 2022 Share Posted June 1, 2022 1 hour ago, pbaker said: We use the Elu-Kit to for the elution and perform tube testing with no additive. Was the Antibody Screen also performed in "the tube" ? Link to comment Share on other sites More sharing options...
Cliff Posted June 2, 2022 Share Posted June 2, 2022 9 hours ago, pbaker said: Malcolm, thank you for the powerpoint, but I can't seem to open it. I attached it below as a pdf. The P1PK Blood Group System.pdf Malcolm Needs, John C. Staley and Ensis01 3 Link to comment Share on other sites More sharing options...
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