Case Study: Immune Alloantibody - LabCE.com, Laboratory Continuing Education

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Case Study: Immune Alloantibody

A 42-year-old patient, born male, underwent open heart surgery six months ago, during which they received six units of Red Blood Cells. At that time, their antibody screen was negative. They have since returned for a follow-up surgery, and their current antibody screen has tested positive with both screen cells at the AHG phase.

Rh-Hr

Kell

Duffy

Kidd

Lewis

MNSs

Lutheran

Vial

Donor

C^w

Kp^a

Kp^b

Js^a

Js^b

Fy^a

Fy^b

Jk^a

Jk^b

Le^a

Le^b

P₁

Lu^a

Lu^b

AHG

R1R1

R2R2

IS = immediate spin; AHG = antihuman globulin; CC = check cells; NT = not tested

Refer to antibody panel reactions below.

	Rh-Hr						Kell						Duffy		Kidd		Lewis		MNSs				P₁	Lutheran
Donor Cell Number	D	C	c	E	e	C^w	K	k	Kp^a	Kp^b	Js^a	Js^b	Fy^a	Fy^b	Jk^a	Jk^b	Le^a	Le^b	M	N	S	s	P₁	Lu^a	Lu^b	IS	37	AHG	CC
1	+	+	0	0	+	0	0	+	0	+	0	+	+	0	+	+	+	0	+	+	+	+	+	0	+	0	0	2+	NT
2	+	+	0	0	+	+	+	+	0	+	0	+	+	+	0	+	0	+	0	+	+	+	+	0	+	0	0	0	+
3	+	0	+	+	0	0	0	+	0	+	0	+	0	+	0	+	0	+	+	0	0	+	+	0	+	0	0	0	+
4	+	0	+	0	+	0	0	+	0	+	0	+	0	0	+	0	0	+	+	+	+	0	+	0	+	0	0	3+	NT
5	0	+	+	0	+	0	0	+	0	+	0	+	+	+	+	+	+	0	0	+	0	+	0	0	+	0	0	2+	NT
6	0	0	+	+	+	0	+	+	0	+	0	+	0	+	+	+	0	+	+	+	+	+	0	0	+	0	0	2+	NT
7	0	0	+	0	+	0	0	+	0	+	0	+	+	0	0	+	+	0	+	0	0	+	+	0	+	0	0	0	+
8	0	0	+	0	+	0	0	+	0	+	0	+	+	+	0	+	0	+	+	+	+	+	0	0	+	0	0	0	+
9	0	0	+	0	+	0	0	+	0	+	0	+	+	+	+	0	0	+	0	+	+	0	+	0	+	0	0	3+	NT
10	+	0	+	0	+	0	+	+	0	+	0	+	0	+	0	+	0	+	0	+	+	0	+	0	+	0	0	0	+
AC																												0	+

IS = immediate spin; AHG = antihuman globulin; CC = check cells; NT = not tested; AC = autocontrol

Observations:

Reactions are occurring at the AHG phase. This indicates an IgG clinically significant antibody.
Reactions are multiple strengths indicating either multiple antibodies or a single antibody showing dosage.
The autocontrol is negative which indicates the patient has an alloantibody.