Ruling out Kell with Heterozygous cells?

[Malcolm Needs ☆]

K is the antigen.  KEL1 derives from the name of the system (Kell) and the 1 derives from the full ISBT number, 006001, because the Kell Blood Group System is the 6th System and the 1 is because the K antigen is the first antigen within the System.  The ISBT number was never "invented" for use in speech, but for use on computers.

[Dr. Pepper]

Other things are that "Cellano" was actually "Nocella", "Lutheran" was actually "Lutteran", the first antibody/antigen discovered in the Kell Blood Group System was anti-Kpc/Kp©, so the system should be called Levay, and the first antibody/antigen discovered in the Diego Blood Group System was anti-Wra/Wr(a), so that system should be called Wright!!!!!!!!!!!!!!!!!!!!!!!!

I had heard the other stories but not the Cellano one. And I can see how 34 years might pass before someone realized that the gene for Levay was an allele at the Kp locus. I'm surprised, though, that BBers who were such careful serologists could be so careless at recording the names of those patients.

[Malcolm Needs ☆]

Guess what Phil.  The Laboratory Technician couldn't read the Doctor's writing in the case of Lutheran/Lutteran.  Ring any bells???????????????!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

[Dr. Pepper]

 

Guess what Phil.  The Laboratory Technician couldn't read the Doctor's writing in the case of Lutheran/Lutteran.  Ring any bells???????????????!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

 All of them!

[goodchild]

We have a patient right now with anti-K that is nonreactive with heterozygous cells.

[AMcCord]

We have a patient right now with anti-K that is nonreactive with heterozygous cells.

We have one that reacts (tube/PeG) 3+ with the one homozygous cell on the panel and hit or miss microscopically with heterozygous cells. Patient was recently transfused, so I'm expecting to see a big fat antibody the next time we see her. 

 

(Sorry Malcolm - I misused those terms again  ).

[Dansket]

Is this the initial presentation of the anti-Kel1 or do both patients have a history of anti-Kel1?

[goodchild]

With my case, the anti-K was identified by cells with homozygous expression in 2005 with similar reactions since then. Patient has been transfused K-neg blood since that time.

Edited July 25, 2014 by goodchild

[AMcCord]

My patient is a new antibody.

[amym1586]

So has anything changed in the last 2 years about this.

I've had two antibody panels come back where K was ruled out on a K+k+ panel cells.   Right or not right?

[Malcolm Needs ☆]

Certainly nothing has changed as far as wrong nomenclature is concerned - despite the best efforts of me, and before me, Peter Issitt!!!!!!!!!!!!!!!

"I've had two antibody panels come back where K was ruled out on a K+k+ panel cells"?  Really amym1586; I thought better of you!!!!!!!!!!!!!!  Nothing personal, by the way.

"I've had two antibody panels come back where ANTI-K was ruled out on K+k+ panel cells."

I refer you to my comment in the thread about ruling in and ruling out and anti-K.

[tbostock]

amym1586: you know you've "made it" on pathlabtalk when you get schooled by Malcolm on the proper nomenclature.  LOL. 

[goodchild]

18 hours ago, amym1586 said:

So has anything changed in the last 2 years about this.

I've had two antibody panels come back where K was ruled out on a K+k+ panel cells.   Right or not right?

Just out of curiosity, are you implying that at your previous establishment K+k- panel cells were required for rule out?

[Dr. Pepper]

1 hour ago, tbostock said:

amym1586: you know you've "made it" on pathlabtalk when you get schooled by Malcolm on the proper nomenclature.  LOL. 

And sometimes it's great fun to "poke the bear!"

I think two points are worth repeating: we happily use antibody screening cells positive for both the K and k antigens all the time and don't worry about missing the rare, weak anti-K that might only react with a hom....ahem, an antigen whose controlling gene is in a homozygous dose. Second, I don't know about your luck, but I buy a 16 and an 11-cell panel and it's quite rare to get a K+k- cell.

I wouldn't worry about it.

[amym1586]

I think I asked my question wrong !    That's my story.

 

It seemed like there was some conflicting advice on of if it was safe to Rule out Anti-K with heterozygous K+k+

At the very end of this post 2 years ago

.......We have a patient right now with anti-K that is nonreactive with heterozygous cells....

I didn't know if after 2 years this had become more prevalent and I needed to change our thinking on rule out panels.

[Malcolm Needs ☆]

As far as I know, and we see an awful lot of them, they have not become more prevalent.

 

Sorry about pulling your leg amym1486!!!!!!!!!!!!!!!!!!!!!!  As you can see from the posts of others, it was nothing personal!!!!!!!!!!!!!!!

[amym1586]

I don't take it personally!    I know I'm a baby tech and always trying to learn so I don't mind being schooled.

 

I study the Technical manual every night and my SBB study guide. So ill get there one day!

Edited January 20, 2016 by amym1586

[Malcolm Needs ☆]

Judging by the standard of your posts, that "one day" will not be too far in the future.

[mollyredone]

We get Ortho 11 cell panels and every B panel is K+k- on cell 22.  I had a patient that had every cell positive on the A panel, so I thought maybe it was an anti-k (we did have one from CAP once), so I ran all the cell 22 (4) that I had.  Turns out a couple of those were positive, so it wasn't anti-k, but I was able to rule out antibodies and come to a positive conclusion!