Hi All

Historical A POS (never phenotyped) no antibodies detected. MDS patient, multi-transfused with APOS/NEG units over past 3 months.

Results

Screening cells (using BioRAD 3 cells) +2 positive reaction only with R2R2 (cell II). DAT +2 (IAT method/ IgG/C3d polyspecific)

Panel negative which suggested a low prevalence/frequency/incidence antibody however - crossmatch was positive which led the question was there was another underlying antibody ( a soup of antibodies).

 

Reference Lab Results

Possible Jka by IAT enzyme and non specific enzyme reactions. Now awaiting genotyping.

Advise to crossmatch Rh/K/Jka D-C-E-Jka-

My question is now the patient has returned to group A POS (there was a dual population before with the D type due to the previous transfusions)

is it acceptable to transfuse D+ (as historically RhD+) C-E-Jka- units or could there be a potential D typing anomaly ?

 

Thanks

 

Edited April 16, 20187 yr by Tabbie
spelling

I can see no reason why you should not transfused D Positive red cells.

Final results

Auto Anti-Jka and nonspecific enzyme IAT ( no requirement to select Jka antigen negative units)

Phenotype E-K- and again Fy GATA mutation negative. 

Has anyone seen an anti-Jka only react by enzyme and not IAT which has not been an auto anti-Jka ?

Thanks

18 hours ago, Tabbie said:

Has anyone seen an anti-Jka only react by enzyme and not IAT which has not been an auto anti-Jka ?

Yes.  As anti-Jk^a is renowned for being labile both in vitro and in vivo, if you "catch" an anti-Jk^a when it is "on the decline" from reacting by IAT and with "enzyme only", you will quite often see an allo-anti-Jk^a reacting only with enzyme-treated red cells - which is part of the reason why they are just SO dangerous, as we would not detect them in an IAT antibody screen.

and often only with enzyme treated cells tested in an IAT....

 

On 5/2/2018 at 3:09 PM, Tabbie said:

Final results

Auto Anti-Jka and nonspecific enzyme IAT ( no requirement to select Jka antigen negative units)

Phenotype E-K- and again Fy GATA mutation negative. 

Has anyone seen an anti-Jka only react by enzyme and not IAT which has not been an auto anti-Jka ?

Thanks

Yes. we see so much anti-Jka in this lab (something must be in the water here). Some reacted only by solid phase, some only by enzyme-IAT but not with peg-IAT method. We type the cells and they were Jk(a-) half the time, in which case we recommended transfusion Jk(a-) blood. 

Has anybody encountered this and look into this? 

Just now, dothandar said:

Yes. we see so much anti-Jka in this lab (something must be in the water here). Some reacted only by solid phase, some only by enzyme-IAT but not with peg-IAT method. We typed the cells by and they were Jk(a-) half the time, in which case we recommended transfusion Jk(a-) blood. 

Has anybody encountered this and look into this?