Yesterday we worked up a patient that had a previous anti-Fyb demonstrating. The previous workups were done on 11/3 and 11/13. Yesterdays sample showed NO anti-Fyb and was demonstrating an anti-E. We had the RN redraw just to verify the patient identity and got the same result. We also pulled the sample from 11/13 and reran the sample and still see the Fyb.

Any thoughts??????

How strong were the reactions on 11/3 and 11/13? What's the patient's history?

How strong were the reactions on 11/3 and 11/13? What's the patient's history?

Patient had 2-3+ reactions in a very obvious Fyb pattern on both 11/3 and 11/13. Diagnosis is a tumor with cirrohsis of the liver, previous cervical cancer (resolved 2002). Kidney tumor (resolved 2008)

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Oh and the anti-E reactions are 3+ also in a very obvious pattern.

Is it possible that the 11/3 samples wer not his?

What drugs is / was s/he given? any steroids, immunsupresssants, etc ?

Was s/he transfused in the meantime and the Ab diluted and cannot be detected.

..... Check these first.

In line with Liz's thought about different patients, you could do a few antigen typings on the 2 specimens to see if there are some glaring discrepancies. (It can get a little complicated if there were some transfusions along the way.)

Was this patient transfused in the last month or so?

We verified that all samples did come from the same patient. The patient was transfused with 2 units on each occasion. So 2 units on the 3rd, 2 on the 13th. I do not think this is enough to cause any kind of antibody dilution.

donnawac, I maybe ask a useless question , I don't know if your SOP include adsorption and elution to identify an antibody, for example,does the anti-Fyb and anti-E been confirmed by use the antigen pos cells to adsorption and elution?

Is the DAT positive?

Is the DAT positive?

DAT was negative. No elution was indicated.

Is it possible that the 11/3 samples wer not his?

What drugs is / was s/he given? any steroids, immunsupresssants, etc ?

Was s/he transfused in the meantime and the Ab diluted and cannot be detected.

..... Check these first.

Liz, I have to point out that if the patient had cervical cancer then "she" is most likely the proper pronoun. Sorry, had to say that. The devil made me do it. Besides I had to beat Malcolm to the punch.

Liz, I have to point out that if the patient had cervical cancer then "she" is most likely the proper pronoun. Sorry, had to say that. The devil made me do it. Besides I had to beat Malcolm to the punch.

Blast!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

:angered::angered:

You boys are bad...but you make me smile and today I needed that...

Thanks

Trish:o

What is the antigen typing for the patient? We have seen several Auto E's lately. Did the previous Fyb react with hetero or homozygous cells exclusively?