Interesting Pt Rh(o)D type

[David Saikin]

I have this 88 yo female with an interesting D type. First saw in our ED in March. Did a quick tube ABORh and O Neg. Complete typing with ABD gel cards was O Pos (anti-D: 3+). We transfused 2 O= rbcs then. This morning my night tech had a 2u xm and set up O= per our pt record. Her typings are the same and I thought I'd share them.

anti-D Rh Ct Weak D

Ortho ABD card 3+ 0 na

Ortho Tube 0 0 1+

Q Biodiag alpha 1+w 0 0

delta 1+ 0 0

blend 1+ 0 1+

Sseraclone 0 0 1+

Obviously something with the mosaic of this ag. Interesting that the 2 QB D's disappeared at weak D testing (I even looked under the scope - barely an agglutinate to be seen) and all weak reactions were verified by sensitized cells.

For your edification and comments. . . . I've noticed that my table does not translate onto the finished product. the results are Dtype/rh ct/ weak D

Edited June 15, 2010 by David Saikin
table did not translate to final post.

[Dar]

Good Luck to you. I've had a thread going on this subject, and you are pretty much validating what I have seen. Try explaining your typing results to an OB physician. LOL!

[Malcolm Needs ☆]

Good Luck to you. I've had a thread going on this subject, and you are pretty much validating what I have seen. Try explaining your typing results to an OB physician. LOL!

Ture, but try explaining an 88-year-old to an OB physician!!!!!!!!!!!!!!!!!!!!!!!!

:eyepoppin:eyepoppin:eyepoppin:eyepoppin:eyepoppin

[David Saikin]

DAR

I actually had 2 OB pts a month apart that were very similar except their gel D was 1+. Could absorb/elute anti-D from their red cells, fetal bleed screen was 2+ macro, weak D was same as IS. They were not related/had the same OB guy.

[BloodBank]

ASCP Teleconference on 5/26/10 Using DNA-Based Testing to Manage Patient Care in Transfusion Medicine is good resource to explain the heterogenicity of D typing. Different anti-D antisera reacts with different parts of D antigen, hence giving different results!!! There is also polymorphism found in E typing.

[Malcolm Needs ☆]

ASCP Teleconference on 5/26/10 Using DNA-Based Testing to Manage Patient Care in Transfusion Medicine is good resource to explain the heterogenicity of D typing. Different anti-D antisera reacts with different parts of D antigen, hence giving different results!!! There is also polymorphism found in E typing.

You are absolutely correct, but there is polymorphism in almost every antigen described. I was amazed, a few years ago, when I attended a lecture given by Martin Olsson, that there were more than 96 genetic backgrounds to the A antigen; I am no longer amazed, following the plethora of papers coming out from Japan and China concerning the genetic background to ABO types.

Good luck to anyone who is trying to keep up to date with all of them!!!!!!!!!!!!!!!!!!!

:eek::eek:

[David Saikin]

Upon futher review of the pkg inserts for the QB anti-D's, the alpha and delta are only IgM anti-D's and shouldn't show up at AHG phase . . . yeah, I've got an IQ.

[Deny Morlino]

Upon futher review of the pkg inserts for . . . yeah, I've got an IQ.

At least you had the logic skills to look further!! It amazes me how poor some tech's logic skills seem to be. Likely you are being harder on yourself than anyone else would be