One sample received different results from different Anti-D reagent:

Ortho: Neg (IgM Anti-D,Colum Column agglutination technology )

DIAMED: POS 4+(IgM Anti-D,Colum Column agglutination technology )

IMMUCOR:POS 4+(IgG Anti-D,IAT AHG)

Any ideas about this case？

THANKS

IME Ortho can be 'undersensitive'. They, and their advocates claim that other technologies are oversensitive but I know of cases of missing a weakly expressed D and in the antibody screen an anti-E that scored 3+ with Diamed. And this is out reference centre... They tell us that it isn't overly senistive so it doesn't find 'rubbish' but IME it misses clinically significant antibodies I'd rather have something oversensitive than something that misses something clinically significant.

Edit-European Ortho using bead technology.

You clearly have some kind of D variant - either a weak D, or, and I think this more likely, a partial D. You need to get it checked out with molecular biology to get a definitive answer.

You clearly have some kind of D variant - either a weak D, or, and I think this more likely, a partial D. You need to get it checked out with molecular biology to get a definitive answer.

Agree.

...if you check the package insert for your anti-D reagents, I think you will find that they contain different clones, which are detecting different epitopes(or not detecting) of the D antigen of your patient.

I believe Ortho column gel does not detect category VI (partial D)!!!!!

I believe Ortho column gel does not detect category VI (partial D)!!!!!

Diamed gives a choice, they have DVI+ (will detect DVI) and DVI- (will find DVI negative).

Oxtail, which Diamed card you use?

This must be an RhD variant because of the big differences between the reagents. If you did not use the DVI+ from Diamed I have not seen this discrepancy (Ortho neg, Diamed 4+), the other way around I have seen.

Peter

Oxtail, what made you pursue the sample and test it with other reagents? Was it a donor, a patient, what was your first result?

I agree; it needs molecular testing.