I have a caucasian patient who is admitted for an infection of hardware in the foot. She shows weak to 1+ reactions at IS and 3-4+ reactions at LISS-AHG and PeG-AHG. DAT and AC are negative. I have one cell negative on a panel and phenotypically matched cells are reactive. She is neg for E, K and Jkb. She is positive for Csa, Vel and PP1Pk. Ficin and DTT treated cells react the same as untreated cells. The titer is 32. Five of six crossmatches are strongly positive, the sixth is weakly positive, but nothing special about that unit. All six units are caucasian donors,R1R1,K-,Jkb-. Any ideas on where to go from here?

Forgot to add, cold auto is proven by RT panel.

I think that this is a case that needs to be referred to a Reference Laboratory (and I don't say that just because I am a Reference Laboratory Manager!!!!!!!!!!).

With the information you have given, I could tell you quite a few specificities that the antibody could not be, but making a stab at a specificity that it could be would only be guesswork.

:confused::confused:

Thank you. I appreciate the advice.

Any time we get an antibody that appears to be to a high frequency antigen, we run a mini panel with all of the high frequency negative cells we can muster. Sometimes we get lucky, but most of the time we end up shipping the sample to a reference lab. It is good to know your limits...