It must be THAT time of year again!

[Malcolm Needs ☆]

I don't know what is going on at the moment, but, in the last two weeks we have had an anti-Ch, an anti-Rg, an anti-Ge2 in a patient with alcoholic liver disease, a pregnant Oh, an anti-Jk3 for surgery, an anti-Yta in pregnancy and an anti-K+Jkb+Csa in a bleeding patient.

Keeps life interesting!

[aafrin]

Malcolm, what a co-incidence we had a pregnant Oh patient for delivery just 3 days ago. They asked for 2 units of PRC to be kept ready. The best thing or worst thing (as you look at it) was that this was her second delivery and they didn't know her blood group. The first delivery was done elsewhere.She already had a 4 year daughter. We spoke to the consultant as well as her husband (he was A+) and stressed about importance of knowing the blood group of their first daughter as well as the propositus's siblings (3 sisters & 1 brother) & parents. He said he will inform them as they were elsewhere, but would bring their daughter for blood grouping next day, which he did not. They just didn't bother. The baby she delivered was A-ve and she was also H Ag negative. Really that time of the year

[Malcolm Needs ☆]

aafrin, thanks for that.

 

One thing I would question though is, if the baby is group A, how could she also by H negative?  If the baby was genuinely H negative, the A antigen could not be expressed.  Could it be that the baby's H antigen was actually positive, but that the alpha-N-acetyl-D-galacosamine was sterically masking the H antigen, and that the H antigen could, in any case, be weakened, as the baby's L-fucosyl transferase would not be working to its full capacity until a bit later in life?

[aafrin]

Malcolm, thanks for answering the query I had in mind.

 

Since the baby was grouped from cord blood I was  wondering whether there could be contamination with mother's blood which was giving this result or something else masking the anti-H reaction.We had asked the father as well as consultant to get the baby's blood checked at two years age (preschool), but wonder whether he will?

 

I know the consultant wouldn't be bothered much since both the mother & child have been well & discharged from the hospital.

[galvania]

IO suspect it's just that the A antigen has 'used up' all the available H; this is quite common in group A1 and AB, depending on the anti-H you use to detect it. Also she would anyway have to be heterozygous for H (Hh)so would probably make less H antigen anyway (not sure about that, though)

[Malcolm Needs ☆]

Yesterday was fun again.

We had a new Oh in pregnancy, a known D--/D-- with, historically anti-E+Rh17, but now with anti-C+E+e+Rh17 going to theatre and an anti-U!

[Dr. Pepper]

Malcolm, thanks for answering the query I had in mind.

 

Since the baby was grouped from cord blood I was  wondering whether there could be contamination with mother's blood which was giving this result or something else masking the anti-H reaction.We had asked the father as well as consultant to get the baby's blood checked at two years age (preschool), but wonder whether he will?

 

I know the consultant wouldn't be bothered much since both the mother & child have been well & discharged from the hospital.

If the child is a secretor you could always look for H in the saliva. what two year old wouldn't like the opportunity to spit in a cup?

[MAGNUM]

Oh the joys of blood banking.

[Dr. Pepper]

But isn't this why we do it? My students all know the correct response to "What's the most fun a blood banker can have?" In unison: "Antibody identification!"

[L106]

Malcolm, it would be greatly appreciated if you keep all those antibody patients on "your side of the pond!"

 

Donna

[Malcolm Needs ☆]

With great pleasure Donna.

My staff were all running around with smiles on their faces that reached from ear to ear!

To quote Phil above:

But isn't this why we do it? My students all know the correct response to "What's the most fun a blood banker can have?" In unison: "Antibody identification!"

[AMcCord]

But isn't this why we do it? My students all know the correct response to "What's the most fun a blood banker can have?" In unison: "Antibody identification!"

 

My only caveat..............not if the patient is bleeding profusely.

[Malcolm Needs ☆]

Last night was interesting again!  Having already done a six and a half hour stretch, I got called in again at about 23.15 for a sample from an elderly lady with an Hb of 60g/L.

 

She had an auto-anti-c using enzyme-treated red cells (although her DAT was negative), a known anti-Lua, a known anti-Fya (neither of which were detected in this current sample, and an anti-Yka by IAT.  Took a bit of sorting!

 

Today was cancelled!!!!!!!!!!!!!!!!!!!!!!!!!!!!