Antibody .... but no stimulant??

[janet]

Yesterday we did a work up on a 52YF going for completion of thyroid. This was follow-up to the partial thyroidectomy done in October.

She was transfused "many years ago" and has 3 children.

October we detected an Anti-K - she was not and has not been transfused since.

Yesterday we detected the Anti-K again what appears to be an Anti-Fya showing dosage (reacts with homozygous cells only + patient is Fya negative).

We use gel - Anti-K was 3+ for both samples.

Any thoughts of what could have stimulated this Anti-Fya ... the Thyroidectomy?? No notes of lymph nodes being taken - thought the manipulation may stimulate T-cells to become active again??

[Malcolm Needs ☆]

Matuhasi-Ogata phenomenon?

More likely, that the anti-Fya was there all the time, but don't forget that the number of antigen sites per red cell differs quite a lot from individual to individual, and the cells used the first time around did not detect the anti-Fya.

[adiescast]

Any chance that an infectious process could stimulate more general antibody production? I've always been curious about that. We used to see many wild antibodies in end stage AIDS patients that reacted with red cells. Occasionally they were even "real" ones.

[Malcolm Needs ☆]

They certainly can. We see an awful lot of "non-specific" panagglutinins in patients about to undergo a THR, particularly if it is a revision, and this is due to infection.

[Mabel Adams]

I wonder if the patient's hydration state could tip a very weak antibody from being detectable one time to undetectable another. Or maybe someone went to lunch while the new panel incubated for 30 min instead of 15.