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comment_39216

Recently we had a gentleman with an anti-Jka. When we consulted with our reference lab on our panel (because we wern't sure) we had asked if we should check the patient for the Jka antigen but they said the didn't recommend that. Why?:confused:

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comment_39218

For me part of the id is to verify the patient is negative for the ag the antibody is directed against.

comment_39219
Recently we had a gentleman with an anti-Jka. When we consulted with our reference lab on our panel (because we wern't sure) we had asked if we should check the patient for the Jka antigen but they said the didn't recommend that. Why?:confused:

Did they give a reason for this particularly left field piece of advice?

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comment_39221

Our reference labs explained it that their policy is to only use the rule out on all the significant antibodies and never go to antigen typing because the antibody may be an auto which would confuse the whole situation.

comment_39223
Our reference labs explained it that their policy is to only use the rule out on all the significant antibodies and never go to antigen typing because the antibody may be an auto which would confuse the whole situation.

That sounds if they do not want to think, that is very odd for a reference lab. A reference lab must make the difference between an allo or an auto antibody, your transfusion advice can/will depent on it.

comment_39224

As Malcolm implied.....somebody is out in left field.

I was trained with (and still follow) David Saikin's rule that testing should be done to prove that the patient's red cells lack the corresponding antigen before reporting out the antibody's specificity.

Now, if your patient's red cells have a Positive Direct Antiglobulin Test, it is a different story. It is true that you cannot type the patient's red cells with any reagent that uses Anti-Human Globulin (Coombs) reagent. The Pos DAT will most likely cause a positive reaction with any AHG-type of antisera, so your results will not be valid. Perhaps this is what your reference lab was trying to explain. (Did your patient have a Pos DAT?)

Donna

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comment_39231

Sorry Donna. didn't see that question on DAT but it was negative.

comment_39233

Then I no longer think that their suggestion was left field - I think that it was actually off the field altogether!!!!!!!!!!!!!!!!

comment_39248

Have you inspected or audited for Reference Laboartory; How do you know that they are qualified to act as a Reference Laboratory for you; I would seek to change laboratories if this is the level of service that you receive. Thank the Lord for Malcolm Needs Laboratory and their services. Most of my staff have benefited greatly from a visit to his laboratory.:D

comment_39255
Have you inspected or audited for Reference Laboartory; How do you know that they are qualified to act as a Reference Laboratory for you; I would seek to change laboratories if this is the level of service that you receive. Thank the Lord for Malcolm Needs Laboratory and their services. Most of my staff have benefited greatly from a visit to his laboratory.:D

At last, a brilliant post!!!!!!!!!!!!!!!!!!!!!!!!

Seriously though, thanks mprandeair.

:blowkiss::blowkiss::blowkiss::blowkiss::blowkiss:

comment_39258

I would say that most of us have benefited from the presence of Malcolm on this site, let alone a visit to his laboratory. THANKS MALCOLM.

comment_39263

Very flattering and thanks everyone, but enough is enough; it's getting embarrassing.

comment_39292

One other thought on your patient's antigen type - was he or she recently transfused? If so, antigen typing would be inappropriate unless a cell separation was performed and the type was done on neocytes.

comment_39316

Does anyone routinely test the pt for Jkb ag if they find anti-Jka (or viceversa)?

comment_39332
Does anyone routinely test the pt for Jkb ag if they find anti-Jka (or viceversa)?

No we don't. What does everybody else do?

Also, Ann, thanks for bringing up the situation of a recently-transfused patient.

comment_39333
Does anyone routinely test the pt for Jkb ag if they find anti-Jka (or viceversa)?

Yes - every time we get one.

The same applies for all other antithetical antigens when we identify an antibody (with the exception of Kp©, or when no grouping antibody is available).

comment_39345
Yes - every time we get one.

The same applies for all other antithetical antigens when we identify an antibody (with the exception of Kp©, or when no grouping antibody is available).

What is the reason for that? We do that for Le(a) antibodies (but that reason is clear) but for non of the other antibodies. Are you looking for null types or what?

Peter

comment_39347

No, we are just "squaring the circle" as we call it - but finding a null type would be great!

comment_39349

I don't usually check for the other antigen, though I have done so if things aren't making sense

comment_39351

I always screen for M and N antigens together. I believe the package insert for one of the antigen manufacturers indicated testing both for valid results quite some time ago.

comment_39360
Does anyone routinely test the pt for Jkb ag if they find anti-Jka (or viceversa)?

Like Malcolm, we test for Jkb every time we get a Jka, and vice versa.

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