Patient hx anti-E, cold and warm

Initial panel IS all negative; AHG 3+ across the board including auto. DAT = 3+ poly HOWEVER, one cell came up negative which is the R2R2 cell which does not make sense. Prior workup had almost the same result but 2+ and the R2R2 cell was called w+.

Any advise on this?

One thing that could be done is run other R2R2cells? But it still wont make sense as to why one comes up negative while there is a strong warm.

Thanks.

Sounds to me like the patient has either an auto-anti-e or an auto-anti-e-like antibody, and that the historic anti-E is now too weak to detect.

Try performing an elution. You may find that this is totally panreactive, although it may still be weaker with the R2R2 cells.

Don't you love warm autos??? Is it real or is it mimicking? The joys of BB.

Why transfusing this patient?