John C. Staley Posted November 3, 2005 Share Posted November 3, 2005 We have a 67 yr old gentleman who types as A1 D positive. His diagnosis is pancytopenia and his medications are Glucophage and amaryl. He looks to have a warm autoantibody but the odd thing is, it appears to have A1 specificity. When crossmatching, the A units are incompatible and the O units are compatible (at least we can transfuse). His DAT is 3+ positive for both IgG and C3d. The reference lab says there are no alloantibodies hiding underneath the auto. They sent absorbed serum which was found to be incomaptible at AHG with type A units as well as A1 reagent cells but A2 cells were compatible. Anyone familiar with auto anti-A1? Link to comment Share on other sites More sharing options...
Lcsmrz Posted November 4, 2005 Share Posted November 4, 2005 Nothing surprises me with antibodies anymore ... Link to comment Share on other sites More sharing options...
John C. Staley Posted November 7, 2005 Author Share Posted November 7, 2005 We just received an update from the reference lab. When they were doing the absorptions they used O cells. It turns out that one of the donors had a very high anti-A1 titer. Their theory is that the anti-A1 from this donor carried through all of the washing steps enough for it to show up when we performed a 45 minute albumin AHG technique. Seems like a stretch but I certainly don't have a better explanation Link to comment Share on other sites More sharing options...
MCPIOR Posted November 12, 2005 Share Posted November 12, 2005 I can understand an auto Anti-A1 and can see that using a standard triple adsorption the reference lab found no underlying alloantibodies. What makes no sense to me is that they attribute an Anti-A1 in their harvested serum to a donor; the patient has Anti-A1 that they have been unable to adsorb out.I would question their interpretation. How are the transfused cells surviving in your patient? Link to comment Share on other sites More sharing options...
John C. Staley Posted November 15, 2005 Author Share Posted November 15, 2005 We transfused type O cells. The patient went home. It's been a couple of weeks and we've not seen them back. I "assume" the transfused cells are doing fine. No way for us to really know unless the patient comes bck for a top up earlier than expected. Link to comment Share on other sites More sharing options...
vkm Posted November 16, 2005 Share Posted November 16, 2005 If the antibody had anti-A1 specificity, why was an autoabsorption necessary? Or did the serum react with group O panel cells? Link to comment Share on other sites More sharing options...
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