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  • Immunohematology


Article | 27-April-2020

On a much higher than reported incidence of anti-c in R1R1 patients with anti-E

A previous study involving tube IATs, untreated RBCs, and a lowionic-strength additive reagent revealed that approximately onethird of R1R1 patients with anti-E have a concomitant anti-c. However,the current study finds a much higher incidence of anti-c in such patients, using gel technology in conjunction with ficinpretreated RBCs. Results of antibody identification studies and transfusion records of 82 R1R1 patients with anti-E were reviewed. Serologic test methods included a LISS wash

W. John Judd, Louann R. Dake, Robertson D. Davenport

Immunohematology, Volume 21 , ISSUE 3, 94–96

Article | 18-October-2020

Red blood cell diluent composition is important for detection of some anti-E

Commercially prepared 0.8% reagent red blood cells (RBCs) eliminate the need to manually dilute 3 to 5% RBCs for use in gel cards. Ortho-Clinical Diagnostics investigated twelve anti-E samples detected in MTS Anti-IgG gel cards using Ortho 3% reagent RBCs manually diluted to 0.8% in MTS Diluent 2™ (MTS2) that were not detected with commercially prepared Ortho 0.8% reagent RBCs. In gel tests, using additional examples of E-positive RBCs, 22 of 26 antiE were reactive when the cells were

Dania D. Yaskanin, Janice L. Jakway, David J. Ciavarella

Immunohematology, Volume 16 , ISSUE 4, 142–146

Article | 17-February-2021

Severe hemolytic disease of the fetus and newborn due to anti-E and anti-Jka

with phototherapy, which continued for 4 days after birth. Blood samples from the mother, father, and baby were sent to the advanced laboratory for further immunohematologic workup. Anti-E and anti-Jka were identified in the mother’s sample (IgG CAT cards) with titers of 8 and 2, respectively. RBC phenotyping of the submitted samples showed the mother to be D+C+c+E–e+;Jk(a–b+), the father to be D+C+c+E+e+; Jk(a+b+), and the baby to be D+C+c+E+e+;Jk(a+b+). Anti-E and anti-Jka were recovered in an

S. Mandal, S. Malhotra, G. Negi, A. Tiwari, S. Mitra, S. Basu, P. Singh

Immunohematology, Volume 36 , ISSUE 2, 60–63

Article | 09-November-2020

Absence of hemolysis after a kidney transplant in an E+ recipient from a donor with anti-E

A 12-year-old Caucasian male with cystinosis received a kidney from his mother, whose red blood cells typed as group O, D+, E–. Her serum contained an anti-E with an IgG1 titer of 16 (score 31). The recipient’s type was group O, D+, E+, with a negative antibody screen in the pretransplant period. The recipient and donor Rh phenotypes were most likely DCcEe and Dccee, respectively. Because the recipient’s mother had no transfusion history, she was probably immunized by the

Marcia C. Zago-Novaretti, Carlos Roberto Jorge, Eduardo Jens, Pedro Enrique Dorihiac-Llacer, Dalton de Alencar Fischer Chamone

Immunohematology, Volume 13 , ISSUE 4, 138–140

Article | 30-November-2020

Hemolytic transfusion reactions due to anti-e+f detectable only by nonstandard serologic techniques

. The patient’s RBCs typed as A, D+, probable Rh phenotype (cDE/cDE). The direct antiglobulin test was negative, and serum samples following the second transfusion were red/brown in color. Serologic investigations were inconclusive on all samples taken until February 13 (after the fourth transfusion). At this time, a weak anti-e reacting by manual polybrene technique and an anti-e+f reacting by two-stage papain technique were detected. The serum also contained potent HLA antibodies. The

Alan Devenish, Lesley A. Kay

Immunohematology, Volume 10 , ISSUE 4, 120–123

Article | 22-November-2020

A comparison of the reactivity of monoclonal and polyclonal Rh reagents with red cells after prolonged storage

Previous studies with stored red cells collected into EDTA anticoagulant had shown that commercial polyclonal anti-C, -c, and -E reagents gave acceptable reactions for 60 days, hut polyclonal antie reagents reliably detected the e antigen only through 14 days. At that time it was noted that a monoclonal anti-e reacted 3+ to 4+ with red cells that no longer reacted, or reacted very weakly, with the polyclonal anti-e reagents. This observation led to a comparison study of the reactivity of

Connie M. Westhoff, Belva D. Sipherd, Larry D. Toalson

Immunohematology, Volume 10 , ISSUE 1, 12–15

case-report | 25-June-2021

Severe perinatal hemolytic disease due to anti-e

an IgG antibody. The passage of these antibodies through the placenta causes a diversity of symptoms in an antigen-positive fetus or newborn, ranging from mild anemia to death.1 Alloimmunization against D during pregnancy is the most frequent cause of severe HDFN, but antibodies to other specificities within the Rh and other blood group systems can also give rise to HDFN. We report a case of HDFN in which solely anti-e was shown to cause severe symptoms. Case Report A white male neonate was born

G. Soler-Noda, Y. Romero-Díaz, L. Orbeal-Aldama, S. Aquino-Rojas

Immunohematology, Volume 37 , ISSUE 2, 72–77

Article | 18-October-2020

Comparison of tube and gel techniques for antibody identification

specificity by both methods. One hundred and ninety-six were reactive only by gel: 25 anti-D, 33 anti-C, 76 anti-E, 13 anti-c, 5 anti-e, 18 anti-K, 7 anti-Jka, 2 anti-Dia, 3 anti-S, 8 combination Rh antibodies (1 with antiK), and 6 other antibody specificities. Two samples were reactive only by PEG-IAT: 1 anti-K and 1 anti-Dia. Four hundred and thirty were positive by the two methods: 156 anti-D, 9 anti-C, 68 anti-E, 15 anti-c, 6 anti-e, 61 anti-K, 12 anti-Jka, 17 anti-Dia, 5 anti-S, 73 combination Rh

Marcia Cristina Zago Novaretti, Eduardo Jens Silveira, Edio da Costa Filho, Pedro Enrique Dorlhiac- Llacer, Dalton de Alencar Fischer Chamone

Immunohematology, Volume 16 , ISSUE 4, 138–141

Case report | 17-November-2020

Case report: a pregnant woman with immune thrombocytopenic purpura and unusual red cell antibodies

Maternal immune thrombocytopenic purpura (ITP) may lead to fetal platelet destruction. This process is mediated by IgG platelet autoantibodies that cross the placenta. In this case, not only were platelet autoantibodies present, but red cell alloantibodies anti-E, anti-M, and anti-He were also present. Anti-E, present as an IgG antibody, crossed the placenta, but did not cause clinical problems in the E+ newborn, other than possible hyperbilirubinemia that was treated by phototherapy.

Carmela R. Nanton, Sharon M. Martin, Lloyd O. Cook, Patricia J. Larison

Immunohematology, Volume 11 , ISSUE 4, 153–155

Report | 01-December-2019

Prevalence of clinically significant red blood cell alloantibodies in pregnant women at a large tertiary-care facility

(3.0%) had one or more unexpected RBC antibodies. Of these 264 women, 107 (40.5%), or 1.2 percent overall, had an alloantibody known to cause HDFN, with a total of 15 different alloantibodies identified. The most common alloantibody found was anti-E (n = 33), followed by anti-M (n = 26) and anti-D (n = 20). In pregnancies of D– women, the most common clinically significant antibodies found were anti-D (n = 20), anti-C (n = 11), and anti-E (n = 2). In pregnancies of D+ women, the most common

Heather M. Smith, Rosetta S. Shirey, Sandra K. Thoman, Jay B. Jackson

Immunohematology, Volume 29 , ISSUE 4, 127–130

Article | 01-April-2020

A confusion in antibody identification:anti-D production after anti-hrB

It is well known that certain combinations of alloantibodies are frequently found together. Patients with sickle cell disease (SCD) are mostly of African ancestry, and they may make anti-hrB. A transfusion of hrB– blood is often achieved by using e– (R2R2) RBCs; it is generally believed that hrB– patients readily make anti-E or a “broad-spectrum” anti-Rh34 (-HrB). We describe two multiply transfused D+ patients with SCD and a history of anti-hrB who subsequently

Christine Lomas-Francis, Rosyln Yomtovian, Claire McGrath, Phyllis S. Walker, Marion E. Reid

Immunohematology, Volume 23 , ISSUE 4, 158–160

Article | 14-October-2020

Acute hemolytic transfusion reaction caused by anti-Coa

-Fya. The patient received six units of RBCs during his initial hospitalization and developed anti-E. A subsequent sample was sent to the reference laboratory when all units of RBCs appeared incompatible. Additional studies, including alloadsorptions, revealed the presence of anti-E, anti-Fya, and an apparent warm autoantibody. One unit of least-incompatible RBCs was transfused during surgery. The patient had an increase in temperature. Hemoglobinuria and a decrease in hematocrit were also noted

Randal B. Covin, Karen S. Evans, Richard Olshock, Hannis W. Thompson

Immunohematology, Volume 17 , ISSUE 2, 45–49

Article | 14-October-2020

Warm autoimmune hemolytic anemia with mimicking anti-c and -E specificities

An 18-month-old male was admitted to a hospital with a hemoglobin of 4.1 g/dL and a reticulocyte count of 53 percent. There was no history of prior transfusion. Serologic evaluation revealed the presence of both a positive direct antiglobulin test (DAT) and an indirect antiglobulin test (IAT). The patient’s red blood cells (RBCs) typed as group A, C–D–E–c+e+ (cde/cde). Evaluation of the IAT revealed the presence of anti-c and anti-E. All other major antibodies were ruled

Hsin-Yeh Hsieh, Diana L. Moroney, Deanne E. Naumann, D. Jane Hata, Nancy C. Vosnidou, Rovenna L. Kessinger, Nassir Shahab, Nasrollah Hakami, Daniel S. Smith

Immunohematology, Volume 18 , ISSUE 1, 19–22

Article | 10-November-2020

Detection of tube agglutination 37°C-only antibodies by solid-phase red cell adherence

There are no published data on the detection of tube agglutination (TA) 37°C-only antibodies by solid-phase (SP) red cell adherence assays using anti-IgG-coated indicator red cells. Thirteen examples of TA 37°C-onIy antibodies were tested by conventional SP methods. Four TA 37°C-only antibodies failed to react by SP. Three were anti-Lea, considered clinically insignificant, and one was anti-E, an anti­body of potential clinical significance. The remaining nine TA 37°C-only

Susan Rolih, Fern Fisher, Dolores Fiqueroa, Gwenn Lindsay

Immunohematology, Volume 12 , ISSUE 1, 27–29

Article | 16-May-2020

Maternal alloanti-hrS - an absence of HDN

A 24-year old female,gravida III,para III,delivered a full-term infant by cesarean section. A maternal blood sample at the time of admission showed antibody in her serum that had apparent anti-e specificity and that her RBCs were e+. Further studies determined that the antibody was anti-hrS. Cord RBCs had a negative DAT and a normal Hb level. There was no clinical evidence for increased hemolysis in the infant. We describe an hrS+ infant with no evidence of HDN due to anti-hrS.

Ram Kakaiya, Jill Cseri, Beth Jochum, Laurie Gillard, Simone Silberman

Immunohematology, Volume 20 , ISSUE 3, 187–189

Report | 01-December-2019

Molecular background of RH in Bastiaan, the RH:–31,–34 index case, and two novel  RHD alleles

available reagents. We tested a cohort of African Americans to estimate the frequency of the RHCE*ce 48C, 733G, 1006T allele, and in addition found two novel RHD alleles. Hemagglutination tests and DNA analyses were performed by standard methods. Analyses revealed homozygosity for RHCE*ce 48C, 733G, 1006T in Bastiaan. RBCs from Bastiaan were strongly agglutinated by three commercial anti-e reagents. Testing RBCs from people homozygous for RHCE*ce 48C, 733G, 1006T showed that anti-e MS16, MS17, and MS63

Marion E Reid, Christine Halter Hipsky, Randall W. Velliquette, Christine Lomas-Francis, Kathleen Larimore, Coral Olsen

Immunohematology, Volume 28 , ISSUE 3, 97–103

Article | 14-October-2020

One thousand seventy antibodies detected only by a 2-stage papain test: wanted and unwanted positive reactions

tested by 2SP were reactive only by the 2SP test. Overall, the 2SP test detected only 0.6% of antibodies considered to be clinically significant (10 examples of anti-c and 2 examples of anti-e). The slight additional safety provided by detection of clinically-significant antibodies is overshadowed by the high number of clinically-insignificant antibodies detected by the 2SP test.

Carmen Martin-Vega, Dolores Castella, Joan Cid, Marta Panadés

Immunohematology, Volume 17 , ISSUE 4, 122–124

Case report | 14-December-2020

Case report and review: alloimmunization, delayed hemolytic transfusion reaction, and clinically significant anti-Yta in a patient with ß-thalassemia/sickle cell anemia

A 26-year-old female with ß-thalassemia/sickle cell anemia was admitted to the hospital with symptoms of a painful crisis. During the next 4 days her hematocrit decreased to 13 percent, and there was reticulocytopenia. She was transfused with four units of red blood cells that were microscopically incompatible, and the hematocrit increased to 29 percent. Eight days later the patient was readmitted with back pain, hemoglobinuria, and a hematocrit of 27 percent. Anti-E, -c, -Jka, and -Yta

Christopher D. Hillyer, Jacquelynn M. Hall, Karen O. Tiegerman, Eugene M. Berkman

Immunohematology, Volume 7 , ISSUE 4, 102–106

Case report | 01-December-2019

A case of masquerading alloantibodies:  the value of a multitechnique approach

) revealed the presence of four alloantibodies: anti-M and anti-E reacting at immediate spin, 37°C, and IAT plus anti-Fya and anti-Jkb reacting at IAT.

Paula M.S. Wennersten, Laurie J. Sutor

Immunohematology, Volume 30 , ISSUE 3, 117–120

Article | 15-April-2020

Serologic and molecular genetic management of a pregnancy complicated by anti-Rh18

Antibodies,such as anti-Rh18 (Hr/HrS),that react with the common products of RHCE can cause HDN as well as severe hemolytic transfusion reactions. Individuals with anti-Rh18 antibodies can have different RHCE genetic backgrounds;therefore,sera and RBCs from these individuals may cross-react. In these situations, genotyping may be the best method to determine compatibility. We report a 26-year-old pregnant Puerto Rican woman who presented at 31 weeks’gestation with anti-E and anti-Rh18 in

Richard L. Haspel, Dawn Michelle, Richard M. Kaufman, Sunitha Vege, Connie M. Westhoff

Immunohematology, Volume 22 , ISSUE 3, 132–135

Article | 14-December-2020

Primary immune response to blood group antigens in burned children

positive direct antiglobulin test (DAT), or both. None of the 11 patients included in the study had been previously tranfused or pregnant. The average number of units transfused prior to antibody identification was 19. The average time elapsed between the first transfusion and antibody identification was 3.6 weeks. Anti-K and anti-E were the most frequently identified. Three patients had a decrease in hemoglobin (average 1.5 g/dL) and hematocrit at the time that a positive DAT was detected. Such

Nancy E. Bacon, Ethel D. Patten, Janet L. Vincent

Immunohematology, Volume 7 , ISSUE 1, 8–11

Case report | 21-March-2020

Hyperhemolytic transfusion reaction attributable to anti-Fy3 in a patient with sickle cell disease

A case of hyperhemolytic transfusion reaction attributable to antiFy3 in a 30-year-oldAfricanAmerican woman with a history of sickle cell disease is reported. The patient was admitted for vaso-occlusive sickle cell crisis and received 4 units of packed RBCs secondary to worsening symptomatic anemia (Hb 5.0 g/dL). On admission,the patient’s antibody screen and identification showed anti-V and antiE,and her antibody history included anti-E,-C,-Jkb,-N,-V,-S,-Sla,and a cold agglutinin with

Meredith A. Reyes, Orieji C. Illoh

Immunohematology, Volume 24 , ISSUE 2, 45–51

Case report | 14-October-2020

Moderate hemolytic disease of the newborn (HDN) due to anti-Rh17 produced by a black female with an e variant phenotype

cause mild to fatal HDN. We report an example of anti-Rh17 produced by a black female with an e variant RBC phenotype that caused moderate HDN. A panel of seven monoclonal anti-e demonstrated her RBCs carried a variant e antigen, and her genotype was RHD, RHce by PCR-RFLP analysis. Amniotic fluid with ΔOD450 values from 30 to 35 weeks’ gestation predicted moderate HDN probability by the Liley method. At 38+ weeks, a viable 3165 g female infant was delivered. The infant’s direct

Marla C. Brumit, Gary E. Carnahan, James R. Stubbs, Jill R. Storry, Marion E. Reid

Immunohematology, Volume 18 , ISSUE 2, 40–42

Case report | 28-April-2020

Case report: immune anti-D stimulated by transfusion of fresh frozen plasma

. Seven months later the patient’s antibody screen remained negative and he was transfused with seven units of D– RBCs and six units of FFP,four of which were D+. Two months later anti-D, -E, and -K were detected in his plasma. Although the anti-E and anti-K could have resulted from transfusion of antigen-positive RBCs, the anti-D could have resulted only from transfusion of the D+ FFP . The D status of FFP is currently not considered when selecting products for transfusion even though the

Marian Connolly, Wendy N. Erber, Dianne E. Grey

Immunohematology, Volume 21 , ISSUE 4, 149–151

Article | 03-November-2020

Improved detection of weak, clinically significant antibodies by supplementation of polyethylene glycol with a low-ionic solution

268 by both saline-IAGTs and RAM-IAGTs. The four antibodies that were not detected were identified as anti-D, anti-E, anti-Bga, and an autoantibody known previously to be only reactive with papain-pretreated red cells. No nonspecific reactions were detected by PEG-IAGTs and no hemolysis was evident in any of the IAGTs. PEG-IAGTs were more sensitive than saline- and RAM-IAGTs. PEG-IAGTs detected all weak, clinically significant antibodies as well as four antibodies that were otherwise undetected by

Kim Swee Low, Yew-Wah Liew, Peter M. Bradley

Immunohematology, Volume 14 , ISSUE 2, 68–71

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