Rule out/Rule in antibody using enzyme panel

[Eagle Eye]

If you are suspecting multiple allo antibodies and when you run enzyme panel:

1) what if cell is positive for enzyme sensitive and enzyme resistant antibody? Eg. If you are suspecting anti-Jka and anti-Fyb and when you are evaluating enzyme panel and the cell which is a) Jka+ & Fyb+ ---if non reactive? Jka+ & Fyb+---what if reaction strength is same or increased?

Thanks

[David Saikin]

In a) - I would expect the anti-Jka is ruled out; in I would say that anti-Jka is probable but that does not r/o anti-Fyb. However, if I also used cell to qc my ficin along with commercial anti-Fyb, then I would feel better that Fyb ag was destroyed if my qc worked . . . does that make sense? I recently had a similar scenario - anti-Fya,-Jsa. The Fya was very obvious . . . when ruling out other abs, the Fya=Jsa+ cell was 2+. The only other cells I had that were Jsa+ were also Fya+b=. I did a ficin pretreatment of the cells and ran them against the patient plasma and also commercial anti-Fya AND also untreated vs the commercial reagent. Both enzyme treated cells were 2+ with the patient serum and Negative with the anti-Fya. The untreated cells were 2+ with the commercial antibody.

[Fluffy agglutinates]

If I was using an Enzyme IAT panel I would use it to rule out Kidd antibodies. However, if it was a standard enzyme technique I definitely would not.