CASE STUDY

Medical History: ◦ 70 year old male ◦ Diagnosis - Malaise and Fatigue ◦ Previous Transfusion History  No previous antibodies identified  Last transfused on 9/13/2011 ◦ Medications - Oxycodone – Acetaminophen, Cholestyramine, Pantoprazole, TraZODone

 Antibody screen 4+ with SCII in Gel  Panel all positive except for 2 cells  Auto control was positive  DAT 4+ in Gel

Anti-AAnti-BAnti-A,BAnti-DA1 CellsB CellsABO Interpretation O Rh Positive PolyspecificAnti-IgGAnti-C3 1+ 0√0√ Testing performed in tubes

RhKellDuffyKiddMNSPLutheran RT-30 Min AHG - PeG DCcEeKkFyaFybJkaJkbMNSsP1P1 LuaLub I II III Auto Control01+

RhKellDuffyKiddMNSP Lutheran Plasma Gel DCcEeKkFyaFybJkaJkbMNSsP1P1 LuaLub Auto Control 1+

RhKellDuffyKiddMNSP Lutheran Plasma Gel P1 Sub Gel DCcEeKkFyaFybJkaJkbMNSsP1P1 LuaLub

RhKellDuffyKiddMNSP Lutheran Plasma Gel P1 Sub Gel DCcEeKkFyaFybJkaJkbMNSsP1P1 LuaLub

 We have identified the anti-P1, -c and –E in the patient’s plasma.  However, we have more to do… ◦ The DAT was positive with anti-IgG ◦ The AC was also positive ◦ Causes – Warm Auto developing, Meds, antibody?

RhKellDuffyKiddMNSP Lutheran Plasma Gel Eluate Gel DCcEeKkFyaFybJkaJkbMNSsP1P1 LuaLub Auto Control 1+NA

RhKellDuffyKiddMNSP Lutheran Plasma Gel Eluate Gel DCcEeKkFyaFybJkaJkbMNSsP1P1 LuaLub Auto Control 1+NA

 Performed on reticulocytes. -c-E-P 1 000

 O positive  Positive DAT with anti-IgG  Antibodies in plasma: anti-P1, -c, -E  Antibodies in Eluate: anti-c, -E  Transfusion recommendations: Transfuse, P1-, c- and E- AHG crossmatch compatible RBCs.