Any Ideas Greatly Appreciated

[David Saikin]

No Patient history. Types as group O, Rh(o)D Positive; DAT: negative

Specimen was referred due to hemolysis noted in gel testing.

Gel panel displayed some weak mf rxs consistent with a cold agglutinin. Ficin pretreatment removed this reactivity A qucik cold panel in tubes revealed a cold auto at 4C with 2 O cord cells reacting as strong as the R1 and R2 cells (2+) - auto and rr were 1+.

A tube panel run with serum/LISS displayed mild hemolysis in all tubes (including auto) after 37C incubation. These cells were reacted with anti-C3b,-C3d after washing - all tubes 4+. A PeG panel with anti-IgG was pristinely negative.

I am open to any and all suggestions. Thanks.

[galvania]

Could this be an anti-Pr? They are destroyed by 'enzymes' but not sure which enzames

[Malcolm Needs ☆]

You got in first Anna. I was going to suggest exactly the same thing!

[David Saikin]

That was my line of thinking also . . . Thanks

[David Saikin]

Enzyme treated cells, in tubes with serume and LISS - no hemolysis at 37 and no agglutination at AHG with anti-C3b,-C3d. I am calling it anti-Pr (if only I had some dog blood . . .).

[Yanxia]

Enzyme treated cells, in tubes with serume and LISS - no hemolysis at 37 and no agglutination at AHG with anti-C3b,-C3d. I am calling it anti-Pr (if only I had some dog blood . . .).

David , what is the use of dog blood? Thank you!

[David Saikin]

Positive for some Pr ags - would be fun to play with.

[Barbarakym]

No Patient history. Types as group O, Rh(o)D Positive; DAT: negative

Specimen was referred due to hemolysis noted in gel testing.

I am open to any and all suggestions. Thanks.

Gel 0.8 cells often show hemolysis when they are contaminated. That is where I go first. Light and being out at room temp too long. I instituted rotating racks so no rack was out more than 8 hours and we keep the 0.8% cells inside a black sleeve to protect from light.

This is frequently the case and often on older cells. When we get a new set the hemolysis goes away.

[David Saikin]

Interesting - I never see hemolysis with my 0.8% cells, even in panels which are 3 months outdated (I always wonder what Ortho does to accomplish that -AND if their treatment accounts for some of the troublesome reactions we see).

Gel 0.8 cells often show hemolysis when they are contaminated. That is where I go first. Light and being out at room temp too long. I instituted rotating racks so no rack was out more than 8 hours and we keep the 0.8% cells inside a black sleeve to protect from light.

This is frequently the case and often on older cells. When we get a new set the hemolysis goes away.

[Barbarakym]

The vials don't look hemolyzed. It's the reaction in the gel which looks hemolyzed. I don't see problems with panels either but they are kept in the fridge. Not routinely sitting on the counter for an entire shift or more. I asked ortho and they said that the sets are validated for 8 hrs at RT. They ASSUME them to be going in and out of fridge. But as a small but busy hospital and with reagents needing to be RT for use we found in our facility that was not happening. They were frequently out 2 shifts st least.