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Anti Mi(a+)?


jojo808

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Hi all,

We had a 78 yr old female O negative pt last year come in as an emergency and got 5 units rbc total, 3 of which were O+ units. We had to switch types due to lack of Rh neg units. Anyway she came back and developed an Anti-D. All D+ cells on 2 panels were 1+. However there was 1 cell out of the panels that had a 4+ reaction. On the 'special/additional' testing column that cell was Mi(a+). Never heard of it, never noticed it on the Ortho panels before. I looked at 2 more panels we had and saw another Mi(a+) cell and tested it and that one tested as 4+ also!

Should I put some kind of comment like "probable/possible Anti-Mi(a+) antibody"?  Our ref lab does not have this antisera. Thanks in advance!!!

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Mia is part of the MNS Blood Group System, and, among most populations (with the exception of the Far East) is a low prevalence antigen.

I would recommend putting "probable/possible", as the problem with antibodies directed against low prevalence antibodies is that 1) people tend to make a "soup" of specificities, rather than a single specificity to a low prevalence antigen, and 2) in any case, such antibodies have a nasty habit of cross-reacting with other low prevalence antigens.

Even if the patient did not have an anti-D, I would recommend that she be disqualified from receiving blood by electronic issue.

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