Workup help

[NightCrawler]

Patient hx anti-E, cold and warm

Initial panel IS all negative; AHG 3+ across the board including auto. DAT = 3+ poly HOWEVER, one cell came up negative which is the R2R2 cell which does not make sense. Prior workup had almost the same result but 2+ and the R2R2 cell was called w+.

Any advise on this?

One thing that could be done is run other R2R2cells? But it still wont make sense as to why one comes up negative while there is a strong warm.

Thanks.

[Malcolm Needs ☆]

Sounds to me like the patient has either an auto-anti-e or an auto-anti-e-like antibody, and that the historic anti-E is now too weak to detect.

Try performing an elution. You may find that this is totally panreactive, although it may still be weaker with the R2R2 cells.

[mrmic]

Don't you love warm autos??? Is it real or is it mimicking? The joys of BB.

Why transfusing this patient?