| When to Use an Enzyme Panel - Results on a Regular Panel Rule-outs can be done using screen cell I and panel cells 4 and 8 (highlighted in green) Antibodies ruled out using these panel and screen cells: C, e, Kpb, Jsb, Jka, Leb, M, P1 and Lub Performing an enzyme panel could help further identify the suspected antibodies. Antibodies needing rule out: D, c, E,K, k, Fya, Fyb, Jkb, Lea, N, S, s If these antibodies are present, a stronger reaction will be seen on the enzyme panel: D, c, E, Jkb, Lea. If these antibodies are present, there will be no reaction on the enzyme panel, since the antigens are destroyed by enzymes: Fya, Fyb, N, S, s. | View Page |
| Case Study Three Rule-Outs Key Antibodies ruled out with 3 reactions: D, c, k, Kpb, Jsb, Leb, P1, and Lub (panel cells used for rule out are in green). Antibodies still needing selected cells for rule outs: C, Lea, E, M, Jkb, S, s (need 2 reactions)Fya,Jka, N, K (need 3 reactions)e, Fyb (needs 1 reaction) Jsa, Kpa, Cw, and Lua all need three reactions for rule-out but these are all low-frequency antigens. It is difficult to find panel cells with these antigens present to allow testing. They will fall in the "unable to rule out" category.Reactions are occurring in the AHG phase only and there is varying strengths of reactivity, which could indicate dosage and/or multiple antibodies.The pattern of reactivity closely matches Fya (cells 2,5,7,8,9 are positive). Of the remaining antibodies that have no rule-out reactions, anti-K is the possible second antibody (present on cell 2 and 10 and screen cell I). Explanation for the varying strengths in reactions: Panel cell 2: Fya (heterozygous) and K present so stronger reaction of 4+. Panel cell 5 and 8: Fya is heterozygous, so weaker reaction of 2+. Panel cell 7 and 9: Fya is homozygous, so stronger reaction of 3+. Panel cell 10: K is (homozygous, so stronger reaction of 3+. | View Page |