HTLA?

[Generic]

We recently had a sickle cell patient come in needing transfusion. She had a previous history of a warm autoantibody, anti-S, and anti-A1.

The screen was positive, 3+, 2+, 2+. The panel came back 2+ down the line, except the C+ cells reacting 3+. The autocontrol and DAT were negative. I ran a ficin panel and it showed up 3+ for all cells, except the C+ cells reacting 4+. At this point I called it an anti-C and unidentified, thinking it was an antibody against a high frequency antigen. After shift change another tech performed a titer and got a result of 32, with all tubes reading 1+. She called it an anti-C and HTLA. My supervisor agreed based on the results of the titer. The strength in the gel and the fact that it was enhanced in the ficin panel make me wonder though. What do you think?

By the way, the patient received at total of 10 phenotypically matched units over the next 8 days, all reacting 1+ to 2+ incompatible in gel, but had no adverse reactions.

[Malcolm Needs ☆]

Some "HTLA" antibodies do react with enzyme treated red cells, but, that having been said, I would be VERY worried about calling this an anti-C+"HTLA" without a lot more work being done on it and, hopefully, getting a true specificity for it.

Without more proof, this sounds a bit like an in vivo compatibility test!!!!!!!!!!

:faint::faint:

Edited May 4, 2011 by Malcolm Needs

[pharez]

can dombrock (doa) be identifed on sample of patient who had no history of any transfusion? thanks

[Malcolm Needs ☆]

It depends on the sex of the patient and, if it is a female, whether or not she has been pregnant.

"No 'naturally occurring' Dombrock antibody is reported, but one anti-Doa was produced in a woman during her first Do(a+) pregnancy." Geoff Daniels, Human Blood Groups, 2nd edition, 2002, Blackwell Science, Chapter 14, page 395.

de la Chapelle A, Vuopio P, Sanger R, Teesdale P. Monosomy-7 and the Colton Blood Groups. Lancet 1975; ii: 817.