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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, continued

The next step is to rule out. The cells used for ruling out are highlighted in yellow. Only cells that had negative reactions in all three phases can be used. Remember to only rule out on homozygous cells, with the exception of K.
As demonstrated in the panel below, cell#2 is the first cell selected for ruling out. D, C, e, CW, K, k, KpbJsb, Jkb, Leb, N, P1, and Lub can all be excluded on this cell. The cells highlighted in pink are heterozygous and are not accepted for rule outs. The exclusion process should continue using all applicable cells.
The image below demonstrates the completed exclusion process. Antibodies to the antigens without highlighting could not be ruled out: Kpa, Jsa, Jka, and Lua. The following antigens are not indicated on the panel: Kpa, Jsa, and Lua. The serum reactions cannot be occurring because of these antigens. The next step is to look for a matching pattern.