I came across cord specimen yesterday.

1) mother A pos...cord specimen anti-A 1+, anti-B 4+, anti-D 4+, DAT neg.

Infant's heel stick specimen is typing same as cord specimen. How would you report this? what additional testing would you perform on this specimen?

We do not use gel for our cord specimen but I use gel to repeat cord specimen. Gel results are same as tube method.

Sounds a lot like

http://www.bloodbanktalk.com/forum/showthread.php?t=2034

I assume you did all the normal things: washed the cells, incubate, etc.

Very interesting..

Aside from the DAT, any negative cells? Did you run an Rh control? What is the prospective fathers type?

Sounds a lot like

http://www.bloodbanktalk.com/forum/showthread.php?t=2034

I assume you did all the normal things: washed the cells, incubate, etc.

Very interesting..

Yes 3X washed cells and with RT incubation little stronger. (1+s).

You are right. I read that case before but I didn't check it today becuase I was so anxious to post here to get some feedback.

Aside from the DAT, any negative cells? Did you run an Rh control? What is the prospective fathers type?

I do not know if I will get father's info. Will try to call clinic tomorrow. According to the tech who worked on it said control was negative. I will repaet that tomorrow. I do not anti-A from different manuf....May be I can use plasma from B pos patient and test it again cord's cell???????

This is interesting...it was a good idea to test a specimen from the heel and an even better one to use plasma from a B donor as your anti-A source. It sounds as though it could be a subgrp. or possibly a B(A) phenotype but I'd defer reporting out a definitive type until the child is older, since it has no clinical significance right now. Let us know how any succeeding results pan out. :juggle:

Just out of curiosity...what anti-sera are you using? Ortho? Immucor? I experienced identical results to yours on a cord last night. Also on the heelstick specimen after extensive washing etc. The cells are negative with anti-A1 lectin and negative with grp. B plasma. I'm confident this is a B pos baby (mom is B neg). Am wondering if we have the same lot # or monoclonal line. Maybe it's something inherent to that line.

Immucor lot# 101664 exp 4/17/08. I got positive result with Ortho lot# BAA557A, exp 5/24/07. Negative with one of the B patient's plasma(pt's plasma 4+ with A1cell).

Actually I have onother cord specimen with same type of result. I am going to call manufacturer tomorrow. Also I wanted to check mixfield which wasn't done so I will do that and anti-A1 lectin.

Both mothers are A type.

Well,

I can tell you that Ortho does use the MHO4 clone and it is in lot # BAA559A but I can't tell you about your lot or Immunocor.

Please keep us informed....

OK, what am I missing? Why can't this baby be AB+? Is it the weak reaction with the Anti-A that's causing the question?

LOL,

That would be too easy and ordinary..........

You would think the reaction for anti-A would be stronger than a 1+ but it is a possibility.........

...In addition to the fact that group B plasma doesn't react to the baby's cells...as you would expect grp B to react against cells having grp A antigen on the erythrocytes. Even if the baby has a subgrp. of "A" antigen, brp B plasma should agglutinate with the cord cells.

I too don't know why they baby can't be an AB pos. You many times have weaker reactions with cord bloods and especially with AB types??????????

The strength of the result with anti-B tells you that there is strong antigen representation on the cell, thus making the 1+ with anti-A quite suspect.

BC

I agree with DANDERS, why can't this baby be AB? Maybe the baby has less A antigen on his cells then expected. Or maybe a subgroup of A.

I don't think anyone said it wasn't possible- just highly unlikely. We don't know the purported father's ABO at this point, so the issue is really not ripe at this point (sorry Mabel- the Lawyer's Code requires us to use legalese at least once a month, and I was running out of time). There is no need to rush into pigeonholing this baby's blood type. It is better to wait 4 or 5 months or so and try again.

BC

Is the mother an A1 type? Mybe you can test the baby's RBC with anti-H. I don't think the baby's A antigen is normal. And to know the purported father's blood type is important to resolve this question.

This is my first post at this forum .Hello,everyone!

I don't think anyone said it wasn't possible- just highly unlikely. We don't know the purported father's ABO at this point, so the issue is really not ripe at this point (sorry Mabel- the Lawyer's Code requires us to use legalese at least once a month, and I was running out of time). There is no need to rush into pigeonholing this baby's blood type. It is better to wait 4 or 5 months or so and try again.

BC

I agree! I think it is a moot point at this time. Wait 4-6 months and retype the baby. I am still voting for a weaker sub-group of A and being an AB. Remember, not all AB's are A1.

I agree with DANDERS, why can't this be an A2B ?

The "A" antigen in newborns is not usually well developed. This fact occasionally results in a weak A typing. You can't test for a weak A subgroup in newborns, the test results are not valid. You might not be able to resolve this problem until the baby is older.

The "A" antigen in newborns is not usually well developed. This fact occasionally results in a weak A typing. You can't test for a weak A subgroup in newborns, the test results are not valid. You might not be able to resolve this problem until the baby is older.

EXACTLY!!!!!!

The "A" antigen in newborns is not usually well developed. This fact occasionally results in a weak A typing.

Yah know, we deliver 300-400 babies a month at my hospital. I have worked up thousands of cord bloods. I have yet to find a single A antigen that typed weakly. I don't buy the "not usually well developed" theory. We may have had some crappy typing sera in the past, but I don't think poorly developed antigens is the case. The literature says that ABO antigens are present within the first trimester. That I buy.

Since this case was originally posted last July--maybe it's time to test the kid again! Of course most moms aren't excited to have their babies' blood drawn so it might be a tough sell.

Since this case was originally posted last July--maybe it's time to test the kid again! Of course most moms aren't excited to have their babies' blood drawn so it might be a tough sell.

That is what I would vote for. I don't think we are going to come up with anything new. And for the comments about weak antigens, or not: Though they might not be weak, (and I agree we don't see too many either), I still think that could indicate a subgroup. who knows it might have just been a fluke!

And, remember, if the baby is AB, the A might be an A2 or other subgroup, which is more common in AB than A.

Since this case was originally posted last July--maybe it's time to test the kid again! Of course most moms aren't excited to have their babies' blood drawn so it might be a tough sell.

It is going to be tough to get baby's specimen just to confirm the type. Right now I have a comment in the computer to alert my staff.