Case Study 1: Immune Alloantibody

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The page below is a sample from the LabCE course Antibody Detection and Identification. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Case Study 1: Immune Alloantibody

A 42-year-old male received six units of Red Blood Cells during open heart surgery six months ago. His antibody screen was negative at that time. He has returned for a follow up surgery and his antibody screen is now positive with both screen cells at the AHG phase.
(IS = Immediate Spin; AHG = Antihuman Globulin Phase; CC = Check Cells; AC = Auto Control; NT = Not tested)
Rh-HrKellDuffyKiddLewisMNSsPLutheran
VialDonorDCcEefVCwKkKpaKpbJsaJsbFyaFybJkaJkbLeaLebMNSsP1LuaLubISAHGCC
IR1R1++00+000++00+++++0++0+++0+003+NT
IIR2R2+0++00000+0+0++0+++0+++++0+02+NT
Refer to Case Study 1 panel below to see reactions of the antibody panel.
Rh-HrKellDuffyKiddLewisMNSsP1Lutheran
Donor Cell NumberDCcEeCwKkKpaKpbJsaJsbFyaFybJkaJkbLeaLebMNSsP1LuaLubIS37AHGCC
1++00+00+0+0++0+++0+++++0+002+NT
2++00++++0+0+++0+0+0++++0+000+
3+0++000+0+0+0+0+0++00++0+000+
4+0+0+00+0+0+00+00++++0+0+003+NT
50++0+00+0+0++++++00+0+00+002+NT
600+++0++0+0+0+++0+++++00+002+NT
700+0+00+0+0++00++0+00++0+000+
800+0+00+0+0+++0+0+++++00+000+
900+0+00+0+0++++00+0++0+0+003+NT
10+0+0+0++0+0+0+0+0+0++0+0+000+
AC0+
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.