SMILLER Posted June 1, 2015 Share Posted June 1, 2015 We have a case where a 55-year old AB neg patient, recently treated for colon cancer, has developed an anti-D. (A few T&S's ago, apparently the anti-D was coming up as a weak equivocal.) She had previously developed an anti-C, and has received about 20 Rh negative units over the past few months.. \ As far as we know, she has never been given anything positive for D (Yes -- including platelets). Can anti-D be induced by something other than an exposure to the D antigen that is present on blood cells? Even if she was exposed in the far past (say by a pregancy where the Rhogam did not work 100%), and her titer had dropped to nothing, what would make it come back up now? Scott Link to comment Share on other sites More sharing options...
goodchild Posted June 1, 2015 Share Posted June 1, 2015 Maybe one of the Rh-negative donors was a DEL? Link to comment Share on other sites More sharing options...
Yanxia Posted June 2, 2015 Share Posted June 2, 2015 Or anti-C and anti-G goodchild, Dr. Pepper, Malcolm Needs and 3 others 6 Link to comment Share on other sites More sharing options...
SMILLER Posted June 2, 2015 Author Share Posted June 2, 2015 The G "pseudo D" theory is interesting. Reading up on it, it appears that certain C positive, D neg red cells can appear to have a D antigen, which would induce anti-D in a D negative recipient. I suppose this may have happened back when this particular patient was initially transfused with presumably C (and G) positive RBCs (before her screen became positive and we started using only C neg units.) And it is only now that the titer has risen high enough to identify the anti-D. The really really weak D el seems to be a possibility also. Additionally, this patient may have gotten IVIG treatment, possibly giving her passive anti-D. Scott Yanxia 1 Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted June 4, 2015 Share Posted June 4, 2015 For what it is worth, my vote is very firmly in the anti-C+G camp. pstruik and SMILLER 2 Link to comment Share on other sites More sharing options...
SMILLER Posted June 4, 2015 Author Share Posted June 4, 2015 Just curious Malcolm, do you see many of these in those D neg patients who are producing anti-C? Scott Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted June 4, 2015 Share Posted June 4, 2015 Hi Scott, I can't give exact figures as 1) I am not at work (and I'm not certain that we keep such figures anyway) and 2) I've just got off a 10 hour flight from Las Vegas, having had a 10 hour flight there a couple of days back, so I am more than a bit jet lagged, but, empirically, we see a surprising number. SMILLER 1 Link to comment Share on other sites More sharing options...
Dr. Pepper Posted June 5, 2015 Share Posted June 5, 2015 Malcolm, if you make your jaunts to the US any shorter you'll be turning around over Nova Scotia. Malcolm Needs 1 Link to comment Share on other sites More sharing options...
Malcolm Needs ☆ Posted June 5, 2015 Share Posted June 5, 2015 Tell me about it Phil!!!!!!!!!!!!!!! Link to comment Share on other sites More sharing options...
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