SbbPerson

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Is it possible that all the RhIg was neutralized by RH positive red cells?

Yes, I am sure they probably order those other tests you mention. But the topic of this thread is on "why titers are not ordered on subsequent pregnancies".

Some mother titers remain high during subsequent pregnancies. Clinical information from the titers would then be misleading. This is why doctors don't order titers on moms who has been sensitized from the first pregnancies.

I am sorry for so many questions. You said the panels tend "to go up individually". What do you mean by that "go up individually"? Can you elaborate more on that? Individually, like by cell#? Thank you .

I am taking the SBB exam this summer. Hopefully, things would be calm down a bit by then and I would be able to take it. Can I ask you, how did you do in your BB Exam? Thank you.

Thank you very much. This have been very helpful. I am sorry, I just have another question. You said you have seen so many of them. What was the cause for majority of those cases you encountered? What was the typical/common reason?

After some mothers are sensitized, their titers can be consistently high during subsequent pregnancies. In some case, even when the baby is Rh positive or Rh negative. The titer in this cases would be not helpful for the doctor to develop a treatment plan for the patient.

I am sorry, but what do you mean by the "panels tend to go up individually"? We just have 2 panels, and both these panels have about 20 cells. So about 40 cells of varying phenotypes. In your original post, you said the "main culprit here is Anti-M". You were right! How did you know exactly?

Thank you for replying. Everything was done by gel card, we don't use the tube method. Patient was typed A Pos. The antibody screen was 1+ positive on Screening cell 1 and 3, negative on Screening cell 2. But when we did the Antibody Identification panel and Auto control , they were all negative. We repeated everything and got the same results. We redrew the patient for a new specimen and got the same results. We sent out the specimen for an Antibody Identification at a reference lab. The result we got back was Anti-M. I am just wondering, why didn't our panels picked this up? Why only the screening cells were positive? What was the reasoning behind this? The panel and all our reagents have passed QC and are not expired. There was no signs of contamination in our specimen or reagents. Thank you.

Thank you for replying. Everything was done by gel card, we don't use the tube method. Patient was typed A Pos. The antibody screen was 1+ positive on Screening cell 1 and 3, negative on Screening cell 2. But when we did the Antibody Identification panel and Auto control , they were all negative. We repeated everything and got the same results. We redrew the patient for a new specimen and got the same results. We sent out the specimen for an Antibody Identification at a reference lab. The result we got back was Anti-M. I am just wondering, why didn't our panels picked this up? Why only the screening cells were positive? What was the reasoning behind this? The panel and all our reagents have passed QC and are not expired. There was no signs of contamination in our specimen or reagents. Thank you.

Thank you for replying. Everything was done by gel card, we don't use the tube method. Patient was typed A Pos. The antibody screen was 1+ positive on Screening cell 1 and 3, negative on Screening cell 2. But when we did the Antibody Identification panel and Auto control , they were all negative. We repeated everything and got the same results. We redrew the patient for a new specimen and got the same results. We sent out the specimen for an Antibody Identification at a reference lab. The result we got back was Anti-M. I am just wondering, why didn't our panels picked this up? Why only the screening cells were positive? What was the reasoning behind this? The panel and all our reagents have passed QC and are not expired. There was no signs of contamination in our specimen or reagents. Thank you.

Thank you for replying. Everything was done by gel card, we don't use the tube method. Patient was typed A Pos. The antibody screen was 1+ positive on Screening cell 1 and 3, negative on Screening cell 2. But when we did the Antibody Identification panel and Auto control , they were all negative. We repeated everything and got the same results. We redrew the patient for a new specimen and got the same results. We sent out the specimen for an Antibody Identification at a reference lab. The result we got back was Anti-M. I am just wondering, why didn't our panels picked this up? Why only the screening cells were positive? What was the reasoning behind this? The panel and all our reagents have passed QC and are not expired. There was no signs of contamination in our specimen or reagents. Thank you.

Thank you for replying. Everything was done by gel card, we don't use the tube method. Patient was typed A Pos. The antibody screen was 1+ positive on Screening cell 1 and 3, negative on Screening cell 2. But when we did the Antibody Identification panel and Auto control , they were all negative. We repeated everything and got the same results. We redrew the patient for a new specimen and got the same results. We sent out the specimen for an Antibody Identification at a reference lab. The result we got back was Anti-M. I am just wondering, why didn't our panels picked this up? Why only the screening cells were positive? What was the reasoning behind this? The panel and all our reagents have passed QC and are not expired. There was no signs of contamination in our specimen or reagents. Thank you.

Thank you for replying. Actually everything was done by gel card, we don't use the tube method. Patient was typed A Pos. The antibody screen was 1+ positive on Screening cell 1 and 3, negative on Screening cell 2. But when we did the Antibody Identification panel and Auto control , they were all negative. We repeated everything and got the same results. We redrew the patient for a new specimen and got the same results. We sent out the specimen for an Antibody Identification at a reference lab. The result we got back was Anti-M. I am just wondering, why didn't our panels picked this up? Why only the screening cells were positive? What was the reasoning behind this? The panel and all our reagents have passed QC and are not expired. There was no signs of contamination in our specimen or reagents. Thank you.

On number 2, you said there was a temperature difference between screen and panel. What did you mean by that? Both screen and panel were performed by Gel cards and incubated at 37 degrees C for 15 minutes.

Can anyone tell me what is going on here and why? Okay, I got a type and screen ordered on a specimen. We did the type , and the patient was A Pos. The antibody screen was positive. Then we did an antibody identification panel, it was all negative, including the auto-control it was also negative. All typing, Ab screen, Ab panel, and auto-control was performed by gel cards. What is going on here and how can we solve it? Thank you.