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Anti-Lua


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We use one from

ImuMed,

ANTITOXIN GmbH,

Industriestrasse 88,

69245 Bammental,

Deutschland

but whether or not this is available and licenced for use in your country, I don't know.

DiaMed also make a card with anti-Lua in the wells/columns, but the same applies about availability and licence.

THe reason they are difficult to come by is that the Lu(a) antigen is a relatively poor immunogen, and the antigbodies formed are usually sub-reagent strength.

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This thing has not been implicated in reactions and does not cause HDN ( or very mild if at all) because of the reasons that Malcolm has cited. It just is not a very good immunogen. So, why exactly are we worried about finding anti-sera? Unless just for ruleouts, but then why also?

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Thank-you Malcom and Lara. Our clients have patients that are mulitply transfused (as I am sure we all do) and some have developed anti Lua. The client asks for Lua negative units for these patients. As a customer service issue we want to provide them. Why is it on the aby id panels? Is it to rule out unexpected reactions?

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Thank-you Malcom and Lara. Our clients have patients that are mulitply transfused (as I am sure we all do) and some have developed anti Lua. The client asks for Lua negative units for these patients. As a customer service issue we want to provide them. Why is it on the aby id panels? Is it to rule out unexpected reactions?

I can see no other reason.

Although the Lu(a) antigen is a poor immunogen, and anti-Lua is usually very weak compared to toher antibodies, it is comparatively common (often, without any known stimulus), and the antigen is quite frequent (about 5% in the Black population and about 8% in the White) and so cross-matching can be a problem; but transfusion is not.

As long as your customers have faith in your work, they should not be asking for Lu(a-) typed blood.

:):):)

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We would NEVER antigen type for Lua. We believe it to be pointless and a huge waste of time!!!!!!

Your question of "Why is it on the panels"... Yes, for no other purpose other than to identify some weird reaction that doesn't match anything else. Look at your panels.....there are many non-sensical (in my opinion) antigens on there. Cw, Jsa, Kpa, Lua, etc, etc.....

It was presented at AABB years ago that if the antigen you are trying to "rule out" on a panel is TOTALLY negative on all cells and you are seeing reactions you can rule out that particular antibody. (Not sure how I feel about this...but I most certainly don't think I know more than the AABB people!!)

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It was presented at AABB years ago that if the antigen you are trying to "rule out" on a panel is TOTALLY negative on all cells and you are seeing reactions you can rule out that particular antibody. (Not sure how I feel about this...but I most certainly don't think I know more than the AABB people!!)

I have to say that I agree with you on this. The way I have always taught it to my students is to think of it as a crime. Just because a person has an alibi (antigen wasn't present on the panel) doesn't mean they weren't involved (antibody could exist in the sample). We would not be *concerned* with some of these antibody specificities for reasons already given, but you cannot say for certain that the antibody is not present in the sample without having a cell that has the antigen present (in enough quantity to detect a corresponding antibody) that fails to react with the sample.

:faq:

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I have to say that I agree with you on this. The way I have always taught it to my students is to think of it as a crime. Just because a person has an alibi (antigen wasn't present on the panel) doesn't mean they weren't involved (antibody could exist in the sample). We would not be *concerned* with some of these antibody specificities for reasons already given, but you cannot say for certain that the antibody is not present in the sample without having a cell that has the antigen present (in enough quantity to detect a corresponding antibody) that fails to react with the sample.

:faq:

True. What you say here is 100% correct. You never know what is underlying....

But "Clinically significant" in relation to transfusion practice as opposed to reference lab identification is different.

I would not EVEN BEGIN to question something AABB put out......If "They"(whoever they are) support a practice we will go with it!!!!!!

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This may be slightly off topic but I thought it would be appreciated by those reading this thread. A few years ago we had a patient with anti-Lua. The antibody was by itself, no other allos, and the patient had been multiply transfused.

When we discovered the antibody we called to our Ambulatory area and told them we would need some time to work it up. When we finished and the RN came upstairs to check out the unit we starting reading the patient demographics, unit number, etc. She got to the Antibody ID field and starts in with "Is this what he has? You're not kidding, is this what he really has? Anti-Lutheran A?"

"yes, we identified an anti-Lutheran A. Why do you ask?". It is a little unusual for nursing staff to ask about this.

"Oh he'll love it, he'll absolutely get the biggest kick out of 'anti-Lutheran A'".

"Okay. Why is that," I asked still not getting the point.

"Because he's a Catholic priest with 'anti-Lutheran A'".

Oh, and no, we do not phenotype for anti-Lutheran A.

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  • 7 months later...

Hi there. I am new to these boards and am almost 5 weeks pregnant. I have a 4 year old boy already. When I was pregnant with my first I was told after a routine blood test that they had found anti LUa antibodies in my blood and I needed to have my blood constantly monitored. At the same time I was going through the nightmare of discovering whether my son had an abnormality as well as very bad sickness and constant fainting. I felt my midwife and doctor did not want to overload me with information about these antibodies as I already had enough to worry about. I was told at the end of the pregnancy that the next time we decided to get pregnant myself and my husband will have to have our bloods taken every week throughout the pregnancy to monitor these antibodies. I am yet to see my doctor for the first time this pregnancy as my surgery is always full but I was wondering if anyone has either been through this before or knows anything about anti LUa antibodies and can shed some light on what I should expect. Any information is welcome as my google searches are leaving me more confused. Thanks everyone!!!

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Hello, congrats on your pregnancy first of all.

While I understand having concern during pregnancy I am a bit confused as to why your doc would mention this at all. The truth is that Lutheran antibodies( Lua and Lub) have not been found to cause issues during pregancy. The most dangerous issue that your doctor is thinking of is called HDN or Hemolytic Disease of the Newborn, this is caused very often by other antibody systems but not Lutheran. This is because for there to a problem your antibodies need an antigen to "attack" in the fetus. Lutheran antigens are not well developed at this age and so are not usually a problem at all for the babies. I am sure most of us on the board will agree that we will use the words usually and most of the time because every now and then there is the exception.

I would continue your prenatal care and do your best not to worry too much about those pesky antibodies and try to have a calm rest of your pregnancy.

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Hello, congrats on your pregnancy first of all.

While I understand having concern during pregnancy I am a bit confused as to why your doc would mention this at all. The truth is that Lutheran antibodies( Lua and Lub) have not been found to cause issues during pregancy. The most dangerous issue that your doctor is thinking of is called HDN or Hemolytic Disease of the Newborn, this is caused very often by other antibody systems but not Lutheran. This is because for there to a problem your antibodies need an antigen to "attack" in the fetus. Lutheran antigens are not well developed at this age and so are not usually a problem at all for the babies. I am sure most of us on the board will agree that we will use the words usually and most of the time because every now and then there is the exception.

I would continue your prenatal care and do your best not to worry too much about those pesky antibodies and try to have a calm rest of your pregnancy.

Great explanation Lara; and I agree 100%.

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In addition to the fact that liamy4 should not worry about anti- Lua because of the poor development of the Lua antigen in the fetus, is the fact that anti-Lua can be naturally occurring secondary to an unknown stimulus. So it is possible that the father and thus the baby do not carry the Lua antigen.

Do not worry as there is no need to.

Liz

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