Desoki Posted October 30, 2011 Share Posted October 30, 2011 I had a case of sickle cell anemia patient 20 years old female with recurrent blood transfusion last transfusion since 2 months, group A+, Ab screen positive with all three cells by IAT only with AHG not in immediate spine or 37c and positive with all cells in panel only with AHG step, also autocontrol positive and DAT positive.I suggest that warm autoantibody but I can’t identify it, so I don’t know how can I select the allogenic cell for alloadsorption or how can I remove this warm autoantibody without disturb the possible alloantibody which is more important than that warm autoatibody?Thanks for help Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted October 30, 2011 Share Posted October 30, 2011 The answer is, you can't, but the chances are that the antibody is not clinically significant.The only thing you could try is alloadsorption with non-enzyme-treated red cells, and see where you get with that. Link to comment Share on other sites More sharing options...
Rh-fan Posted October 30, 2011 Share Posted October 30, 2011 You can select different cells for the absorption (lets say 3) that are different in antigen typing. On these three cells every antigen must be negative at one cell (minimal). In that way every allo antibody will be left over after the absorption with one of the cells.The (only) problem is that antibodies against a high frequent antigen will be removed by all 3 cells. Specialy in youe case there is a great change that you patient is Fya-b- so maybe it is smart to get a Fya-b- donor as one of the absorption cells. That last option we only perform when we see unaspected red cells destruction.Peter Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted October 30, 2011 Share Posted October 30, 2011 Yes, that's sort of what I meant (but, looking back on my post, I could have put it a LOT better!).I understood, from the original post, that the antibody was not reacting with enzyme-treated red cells, which would rule out an anti-Fy3, so why include an Fy(a-b-)? Link to comment Share on other sites More sharing options...
Rh-fan Posted October 31, 2011 Share Posted October 31, 2011 I do not see that the antibody is non reactive with enzyme but in the netherlands it is quite common to perform a enzym test only in direct agglutination. Then sometime anti Kell HFA antibodies are non reactive so you are not able to rule out any antibodies. The problem is that you have to be sure wich enzyme technic is used, IAT or direct agglutination. Link to comment Share on other sites More sharing options...
Desoki Posted October 31, 2011 Author Share Posted October 31, 2011 The answer is, you can't, but the chances are that the antibody is not clinically significant..I didn't react this sample with enzyme treated cells, but If I treat that sample with enzymed panel and result give me negative is this prove that Ab nonclinicaly significant? Link to comment Share on other sites More sharing options...
Rh-fan Posted October 31, 2011 Share Posted October 31, 2011 it gives you no information on the clinical significans but it can help you with determining the specificity Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted October 31, 2011 Share Posted October 31, 2011 it gives you no information on the clinical significans but it can help you with determining the specificityAgreed. Link to comment Share on other sites More sharing options...
Desoki Posted October 31, 2011 Author Share Posted October 31, 2011 The answer is, you can't, but the chances are that the antibody is not clinically significant.The only thing you could try is alloadsorption with non-enzyme-treated red cells, and see where you get with that.One friend told me he heard about commercial Kit can remove warm autoantibody from the mixture leaving the plasma free from autoantibody so can test for possible alloantibody, Is it true and if true how that kit works? Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted October 31, 2011 Share Posted October 31, 2011 I must admit, I've never heard of it (and I certainly wouldn't trust it), unless you are talking about WARM, in which case I have heard of it, and I still don't trust it! Link to comment Share on other sites More sharing options...
L106 Posted October 31, 2011 Share Posted October 31, 2011 I can't pass this one up.....WARM reagent is used most frequently in an auto-adsorption procedure (and since msdesoki's patient has been recently transfused she is not a candidate for an autoadsorption.)But Malcolm....I'd like to hear what you have to say about the WARM reagent, and why don't you trust it? (Thanks!)Donna Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted October 31, 2011 Share Posted October 31, 2011 I can't pass this one up.....WARM reagent is used most frequently in an auto-adsorption procedure (and since msdesoki's patient has been recently transfused she is not a candidate for an autoadsorption.)But Malcolm....I'd like to hear what you have to say about the WARM reagent, and why don't you trust it? (Thanks!)DonnaOh Good Lord Donna - you are absolutely and utterly correct. I can't believe I posted that!!!!!!!! Mia Culpa, mia culpa.Bang goes any chance of an invite to lecture at the AABB.I'll tell you why I don't trust WARM tomorrow (if I can show my face on PLT). Link to comment Share on other sites More sharing options...
L106 Posted October 31, 2011 Share Posted October 31, 2011 No, you misunderstood, Malcolm........ I meant that I could pass up asking you to share your thoughts/opinions about WARM.(I'll check on your response tomorrow.) Link to comment Share on other sites More sharing options...
Desoki Posted November 1, 2011 Author Share Posted November 1, 2011 I can't pass this one up.....WARM reagent is used most frequently in an auto-adsorption procedure (and since msdesoki's patient has been recently transfused she is not a candidate for an autoadsorption.)What is W.A.R.M reagent you talked about it, it is first time I heard about it, if possible send me link to it's package insert or send it me by email msdesoki@yahoo.comthanks for help. Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted November 1, 2011 Share Posted November 1, 2011 What is W.A.R.M reagent you talked about it, it is first time I heard about it, if possible send me link to it's package insert or send it me by email msdesoki@yahoo.comthanks for help.I can't do this, as we do not use it. Please could someone else help? Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted November 1, 2011 Share Posted November 1, 2011 No, you misunderstood, Malcolm........ I meant that I could pass up asking you to share your thoughts/opinions about WARM.(I'll check on your response tomorrow.)I may have misunderstood you Donna, but I was still WRONG!The reason I wouldn't use W.A.R.M. is because, unlike REsT, where we know what antibodies are removed (including anti-, and most of those removed (except anti- are not going to be clinically significant (because they are "cold"), with W.A.R.M., the whole reason for using it is to remove the auto-antibody to see what is underneath it, but we do not know for sure what else may be removed (as it has not been tested against every clinically significant antibody ever detected), and, as it is removing "warm" antibodies, there is a higher chance that it is removing an underlying "warm" clinically significant antibody.Just my opinion. Link to comment Share on other sites More sharing options...
AMcCord Posted November 1, 2011 Share Posted November 1, 2011 W.A.R.M. is a lyophilized mix of DTT and cysteine-activated papain in a phosphate buffer. It's sold by Immucor. Link to comment Share on other sites More sharing options...
Rh-fan Posted November 1, 2011 Share Posted November 1, 2011 Is WARM not a comercial name for ZZAP. Which can be used to clean the patients cells form attached IgG antibodies so you can use then for an auto absorption. It is not to remove antibodies from a serum but to clean the cells so these can be used to remove antibodies from the serum. I see no hard in using this (in case of an un-transfused patient).Peter Link to comment Share on other sites More sharing options...
Desoki Posted November 2, 2011 Author Share Posted November 2, 2011 I know ZZAP but i didn't know other name WARM Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted November 2, 2011 Share Posted November 2, 2011 Is WARM not a comercial name for ZZAP. Which can be used to clean the patients cells form attached IgG antibodies so you can use then for an auto absorption. It is not to remove antibodies from a serum but to clean the cells so these can be used to remove antibodies from the serum. I see no hard in using this (in case of an un-transfused patient).PeterQuite correct Peter.I have had a complete brain block over this thread and realise that I have been talking complete tosh.Sorry about that everyone.:surrender:surrender:surrender:surrender:surrender:slap::slap::slap: jojo808 1 Link to comment Share on other sites More sharing options...
Desoki Posted November 2, 2011 Author Share Posted November 2, 2011 Anyone can help me to solve this problem by send me isert of WARM reagent...!!!!my email is msdesoki@yahoo.com Thanks my friends Link to comment Share on other sites More sharing options...
MAGNUM Posted November 2, 2011 Share Posted November 2, 2011 I must admit, I've never heard of it (and I certainly wouldn't trust it), unless you are talking about WARM, in which case I have heard of it, and I still don't trust it!If it is indeed WARM, don't waste your money or time, in my humble opinion it doesnt work appropriately. Link to comment Share on other sites More sharing options...
Eagle Eye Posted November 8, 2011 Share Posted November 8, 2011 (edited) [ATTACH]567[/ATTACH]I will try to attach it here: Edited November 8, 2011 by aakupaku like to add attachement Link to comment Share on other sites More sharing options...
Desoki Posted November 8, 2011 Author Share Posted November 8, 2011 many thanks for aakupaku Link to comment Share on other sites More sharing options...
Liz Posted November 10, 2011 Share Posted November 10, 2011 If it is indeed WARM, don't waste your money or time, in my humble opinion it doesnt work appropriately.It is awfully time consuming, but what happened to make you say that it doesnt work? Link to comment Share on other sites More sharing options...
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