jschlosser Posted October 13, 2011 Share Posted October 13, 2011 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? Link to comment Share on other sites More sharing options...
David Saikin Posted October 13, 2011 Share Posted October 13, 2011 For me part of the id is to verify the patient is negative for the ag the antibody is directed against. Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted October 13, 2011 Share Posted October 13, 2011 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?Did they give a reason for this particularly left field piece of advice? Link to comment Share on other sites More sharing options...
L106 Posted October 13, 2011 Share Posted October 13, 2011 Sorry, no good explanation here. You need to ask your reference lab why.Donna Link to comment Share on other sites More sharing options...
jschlosser Posted October 13, 2011 Author Share Posted October 13, 2011 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. Link to comment Share on other sites More sharing options...
Rh-fan Posted October 13, 2011 Share Posted October 13, 2011 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. Link to comment Share on other sites More sharing options...
L106 Posted October 13, 2011 Share Posted October 13, 2011 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 Link to comment Share on other sites More sharing options...
jschlosser Posted October 13, 2011 Author Share Posted October 13, 2011 Thanks to all of you. Very helpfull feedback. Link to comment Share on other sites More sharing options...
jschlosser Posted October 13, 2011 Author Share Posted October 13, 2011 Sorry Donna. didn't see that question on DAT but it was negative. Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted October 13, 2011 Share Posted October 13, 2011 Then I no longer think that their suggestion was left field - I think that it was actually off the field altogether!!!!!!!!!!!!!!!! Link to comment Share on other sites More sharing options...
mprandealr Posted October 14, 2011 Share Posted October 14, 2011 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. Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted October 14, 2011 Share Posted October 14, 2011 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.At last, a brilliant post!!!!!!!!!!!!!!!!!!!!!!!!Seriously though, thanks mprandeair.:blowkiss::blowkiss: Link to comment Share on other sites More sharing options...
David Saikin Posted October 14, 2011 Share Posted October 14, 2011 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. Link to comment Share on other sites More sharing options...
Deny Morlino Posted October 14, 2011 Share Posted October 14, 2011 I must agree with David ... thanks Malcolm! Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted October 14, 2011 Share Posted October 14, 2011 Very flattering and thanks everyone, but enough is enough; it's getting embarrassing. Link to comment Share on other sites More sharing options...
Liz Posted October 17, 2011 Share Posted October 17, 2011 Just one more Malcolm, Thank you!! Link to comment Share on other sites More sharing options...
AMcCord Posted October 17, 2011 Share Posted October 17, 2011 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. Link to comment Share on other sites More sharing options...
David Saikin Posted October 18, 2011 Share Posted October 18, 2011 Does anyone routinely test the pt for Jkb ag if they find anti-Jka (or viceversa)? Link to comment Share on other sites More sharing options...
L106 Posted October 18, 2011 Share Posted October 18, 2011 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. Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted October 18, 2011 Share Posted October 18, 2011 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). Link to comment Share on other sites More sharing options...
Rh-fan Posted October 19, 2011 Share Posted October 19, 2011 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 Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted October 19, 2011 Share Posted October 19, 2011 No, we are just "squaring the circle" as we call it - but finding a null type would be great! Link to comment Share on other sites More sharing options...
AMcCord Posted October 19, 2011 Share Posted October 19, 2011 I don't usually check for the other antigen, though I have done so if things aren't making sense Link to comment Share on other sites More sharing options...
jayinsat Posted October 19, 2011 Share Posted October 19, 2011 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. Link to comment Share on other sites More sharing options...
MAGNUM Posted October 19, 2011 Share Posted October 19, 2011 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. Link to comment Share on other sites More sharing options...
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