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We recently titered 40 O plateletpheresis donors and found that the DTT treated samples correlated well with titers that were incubated at 37C for 60 minutes and testing at IAT using anti-IgG. We are still reviewing all the data but that was one of our noted results.

We did do a 56C heat eluate of the patient's cells and then an autoadsorption x 3 with 3+ results on all cells tested including the phenotypically similar.

We believe that this is an autoantibody also, but the fact it won't adsorb and the its high titer are baffeling. We ran EGA treated, DAT negative autocontrol with all panels and it reacted...indicating it's an autoantibody. The PEG adsorbing cells were not enzyme treated and we ran three (3) phenotypically similar cells with all adsorbed sera with positive results.

70 year old, African American female, never transfused, 2 live children, no major surgeries. O Positive, R2R2 K-, Fy(a-b-), Jk(a+b+), M+N-S-s+ phenotype per BioArray but genotypically Fy(a-b+) with GATA BB, so Fyb is silenced. DAT poly: 3+; IgG 3+; C3b3d: Weak; Saline: Neg PEG 4+ all cells tested. 22% albumin 2+ all cells tested. Acid eluate reacts with all cells tested. Papain treated cells and 0.2M DTT treated cells react 3+; no difference. Adsorbed X 5 with PEG R1R1, R2R2 and rr cells: 1+ to 2+ Adsorbed x 5 wih Papain treated R1R1 etc: 3+; autoadsorbed, heat eluted, papain treated cells x 3: 3+ Titer to 2048 with prozone effect between 1:8 (3+), 1:16 to 1:64 (4+), 1:128 back to 3+ Patient phenotypes: H+, P+, At(a+), Cr(a+), Vel+, Tc(a+), Lan+ Patient serum reacts with: cord cells, JMH-, Yk(a-), McC(a-), Kn(a-), Sl(a-), Wr(a-), Jr(a-), N-U-, Lu(a-b-) Genotype shows all "Normal" high incidence antigens present

A sample was sent to us on a 32 year old pregnant patient about to deliver. Historically she was an A Positive but she presented this time as an O Positive. The reverse typing was 2+ with A1 cells and 3+ with B cells. We have seen cases where the ABO antigens were decreased or altered during pregnancy but this was the first case that I have seen in 35 years where the A antigen was not detected. We performed an adsorption/elution study and the patient did adsorb and elute anti-A. I thought this was interesting and wanted to share; without a history this lady could have been called an O Pos. She typed as A1-, but we doubt the typing since there wasn't any reaction with monoclonal anti-A.

The Lewis substance is commercially prepared, Immucor/Gamma. The product insert does not specify an ABO. Under limitations it is noted that anti-H is also neutralized.

The patient is an O Positive.

81 year olf female admitted for respiratory distress. Phenotypes Le(a-b+). No reactivity detected using LISS tube technique. Using PEG, the only reactivity detected was with five Le(a+) cells. The Le(a+) cells reacted weak to 1+. This reactivity was not abolished by Le substance.