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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

Case report | 26-October-2019

Severe hemolytic disease of the fetus and newborn due to anti-C+G

Anti-G is commonly present with anti-D and/or anti-C and can confuse serological investigations. In general, anti-G is not considered a likely cause of severe hemolytic disease of the fetus and newborn (HDFN), but it is important to differentiate it from anti-D in women who should be administered anti-D immunoglobulin prophylaxis. We report one woman with three pregnancies severely affected by anti-C+G requiring intrauterine treatment and a review of the literature. In our case, the

Riina Jernman, Vedran Stefanovic, Anu Korhonen, Katri Haimila, Inna Sareneva, Kati Sulin, Malla Kuosmanen, Susanna Sainio

Immunohematology, Volume 31 , ISSUE 3, 123–127

Case report | 09-November-2020

Case report: reporting anti-G as anti-C+D may have misleading clinical implications

Four months after a D– male was transfused with four units of D– red blood cells (RBCs), the results of a standard pretransfusion antibody screen and alloantibody identification panel detected anti-C+D in his serum. This report was interpreted by his physician to be evidence of alloimmunization to the D antigen, which triggered concern that the patient had been transfused previously with D+ RBCs as the result of an error in blood typing or personal identification. After a review of

Archiaus L. Mosley, Jr., Mary Beth Trich, Nanette C. Thomas, S. Gerald Sandler

Immunohematology, Volume 13 , ISSUE 2, 58–60

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

Case report | 16-October-2019

A delayed and acute hemolytic transfusion reaction mediated by anti-c in a patient with variant RH alleles

RHCE*ceEK/ RHCE*ceAR alleles. The patient was previously alloimmunized to D, C, and E and possibly hrS. Further transfusion of D–C–E–K– RBCs resulted in a suspected acute hemolytic transfusion reaction and the subsequent identification of anti-c. Monocyte monolayer assay testing suggests clinical significance with a range of 29.5–38.5 percent reactive monocytes.

Tiffany K. Walters, Thomas Lightfoot

Immunohematology, Volume 34 , ISSUE 3, 109–112

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

Article | 27-December-2020

Resolution of discrepant typings observed in paternity testing

Discrepant results in phenotyping the red blood cells (RBCs) of a child and his alieged parents were attributable to a contaminating antibody, anti-Bgb (HLA B-17), in typing reagents (anti-C and -CW). This case demonstrates the necessity for using reagents from at least two sources for paternity testing.

Mary Lou Guizzo, Nancy Lang

Immunohematology, Volume 5 , ISSUE 2, 57–59

Case report | 09-October-2019

Autoanti-C in a patient with primary sclerosing cholangitis and autoimmune hemolytic anemia: a rare presentation

-reactive AIHA. Further testing showed the possibility of anti-C. The patient’s Rh phenotype was C+D+E–c– e+. Further testing with select cells, serial alloadsorption, and an elution confirmed anti-C specificity. The patient was transfused with two C–, crossmatch-compatible packed red blood cell units. The patient’s hemoglobin level and general condition showed improvement. This unique case report shows PSC associated with AIHA caused by autoanti-C. Usually, warm AIHA

Meenu Bajpai, Ashish Maheshwari, Shruti Gupta, Chhagan Bihari

Immunohematology, Volume 32 , ISSUE 3, 104–107

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

Article | 10-November-2020

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

antibodies reacted by SP, including three anti-c, two anti-D, two anti-E, one anti-N, and one anti-M. The anti-M reacted with indicator red cells that lacked the red cell antigen and failed to react with IgG-coated indicator red cells whose anti-IgG component had been neutralized, indicating the antibody contained an IgG component. Two anti-D and one anti-c continued to react in an SP test using neutralized anti-IgG antigen-positive indicator red cells, i.e., indica­tor binding independent of

Susan Rolih, Fern Fisher, Dolores Fiqueroa, Gwenn Lindsay

Immunohematology, Volume 12 , ISSUE 1, 27–29

Case report | 15-April-2020

Case report:moderate hemolytic disease of the newborn due to anti-G

after birth until day of life 20. Anti-G was identified and anti-C and -D excluded in the mother’s serum. In contrast to the previous report, this report shows anti-G alone can cause moderate HDN and that fetal monitoring and treatment may be necessary.

Aaron R. Huber, George T. Leonard, Rita W. Driggers, Sakhone B. Learn, Colleen W. Gilstad

Immunohematology, Volume 22 , ISSUE 4, 166–170

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

Article | 30-November-2020

Autoimmune hemolysis following transfusion: a mimicking autoanti-D in a D- patient with alloanti-D

An 80-year-old group O, D- (rr) female with anti-C, -D, -E, and -Fya received four units of crossmatch-compatible red blood cells (RBCs). The direct antiglobulin test (DAT) was negative. Two weeks later, jaundice, dark urine, a 16% drop in hematocrit (Hct), a 20% reticulocyte count, and absent haptoglobin occurred. During the next month, her DAT was positive with anti-IgG and -C3d. Acid eluates, which repeatedly showed anti-D specificity, were nonreactive with enzyme-treated D- RBCs. Adsorption

Walter H. Dzik, Joyce Blank, Paula Lutz, Thomas G. Hirose, Christine Lomas-Francis, Marilyn Moulds

Immunohematology, Volume 10 , ISSUE 4, 117–119

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

were identified. The direct antiglobulin test was positive, and the eluate contained anti-c and -Jka. The patient’s hematocrit continued to decrease to 14 percent. Transfusions were withheld and the patient recovered uneventfully. Separate 51Cr red blood cell survival studies showed significantly shortened survival of both autologous and R1R1, Jk(a-), Yt(a+) erythrocytes. This case illustrates the complexity of transfusion management in hemoglobinopathy patients.

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

Immunohematology, Volume 7 , ISSUE 4, 102–106

Report | 12-March-2020

RHCE*ceAR encodes a partial c (RH4) antigen

The Rh blood group system is highly complex both in the number of discrete antigens and in the existence of partial antigens, especially D and e.  Recently, several partial c antigens have been reported. Here we report findings on an African American man with sickle cell disease whose RBCs typed C+c+ and whose plasma contained anti-c. Hemagglutination tests, DNA extraction, PCR-RFLP, reticulocyte RNA isolation, RT-PCR cDNA analyses, cloning, and sequencing were performed by standard

Marion E. Reid, Christine Halter Hipsky, Christine Lomas-Francis, Akiko Fuchisawa

Immunohematology, Volume 26 , ISSUE 2, 57–59

Article | 18-October-2020

Large-scale use of red blood cell units containing alloantibodies

-containing RBC units, and 253 of these were transfused to 187 patients. Follow-up samples were received on 99 of these187 patients, and 10 of these patients had detectable passive antibody in posttransfusion antibody screening tests. Two patients had anti-C and -D and eight patients had anti-D. Due to our negotiation of a small discount for antibody-containing units and the use of 20 units based on labeled phenotype rather than antigen typing in our laboratory, we experienced a net savings of $3814 over

Martha R. Combs, Donald H. Bennett, Marilyn J. Telen

Immunohematology, Volume 16 , ISSUE 3, 120–123

Article | 17-February-2021

Blood component administration to multiple myeloma patients treated with daratumumab: suggesting a novel approach with use of 0.1 M dithiothreitol

(Ortho BioVue cassettes, Ortho Clinical Diagnostics) were used as per the manufacturer’s instructions on a semi-automated platform (Ortho BioVue, Ortho Clinical Diagnostics). Extended phenotyping (C, c, E, e, K, k, Fya, Fyb, Jka, Jkb, M, N, S, s, Lea, Leb, P1): Extended phenotyping was performed by conventional tube test (CTT) using corresponding antisera (Anti-C, Anti-c, Anti-E, Anti-e, Anti-K, Anti-Fya, Anti-Fyb, Anti-Jka, Anti-Jkb, Anti-M, Anti-N, Anti-S; Immucor and Anti-k, Anti-P1, Anti-s, Anti

P. Pandey, D. Setya, E. Kaul, S. Ranjan, M.K. Singh, A. Shankar

Immunohematology, Volume 36 , ISSUE 4, 157–165

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

Report | 29-October-2019

Indirect antiglobulin test-crossmatch using low-ionic-strength saline–albumin enhancement medium and reduced incubation time: effectiveness in the detection of most clinically significant antibodies and impact on blood utilization

minutes of incubation exhibited the same performance as LISS-albumin, PEG, and gel with 15 minutes of incubation. Conventional tube method results were equally comparable, but reactions were significantly less intense, except for anti-c (p = 0.406). Accuracy was 100 percent for all selected methods. After the implementation of the 5-minute IAT-XM protocol, the C:T ratio fell from 2.74 to 1.29 (p < 0.001). IAT-XM can have its incubation time reduced to 5 minutes with the use of LISS-albumin

Carla Luana Dinardo, Sílvia Leão Bonifácio, Alfredo Mendrone Júnior

Immunohematology, Volume 30 , ISSUE 1, 1–5

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