case with anti-e

[Eagle Eye]

We had a case last week.

We use gel testing: panel A 4 out of 11 cells are non reactive(different strength 1+ to 3+). PAnel C untreated almost same result. Panel C ficin treated 10 cell reactive (neg cell is e-) with different strength of reaction, 1+ to 4+. 19 units were compatible(by gel- provue and manual gel). Later all unit tested e+. We order e- units from blood center and all were compatible. Autocontrol negative.

Please give me your input on this case. THank you.

[janet]

I've come across this a couple times now. Gel showing weak reactions and some missing positives, my "gut" telling me it's an anti-e....confirmed by our reference lab (not sure if only by PEG IAT or they actually did enzymes).

I've even had this happen when I make up antibody samples for students...add anti-e for them to work up but not all cells react the same (1+ to weak, some missing)....could be the monoclonal reagent I'm using in these cases I guess.

?????

[labgirl153]

Have seen similar problem with the 0.8% cells in gel. For example, last week on running the 3-cell screen, one cell popped up as 1+ weak. I knew immediately that on running Panel A that nothing would show up (and on running it, all ortho cells were negative). So...I reduced some Immucor cells from 3% to 0.8% and ran those in gel against thte patient. They came up beautifully...anti-E with...all homozygous expression.

I know Ortho has sent the bulletin on their diluent problem with the 0.8%panel cells but they only mentioned a problem with picking up on anti-E and anti-K. I suspect other antibodies might be tough to pick up if the antibody isn't strong or is showing dosage. This might be the case with your anti-e as well?