<abstract xmlns="http://www.w3.org/1999/xhtml">In an immunohematology reference laboratory, samples received for antibody identification react in many different ways requiring a variety of approaches. Sometimes, the clues from initial testing can lead to faulty assumptions and misdirection. Fortunately, a well-supplied reference laboratory will have access to a variety of techniques and reagents that, when used together, can reveal the true identity of the antibodies involved. We present a case of a patient sample with an apparent group AB, D+ blood type showing strong reactivity with all cells tested in the forward and reverse ABO, in the D testing as well as in a three-cell antibody screen. The initial assumption was that the plasma contained a cold autoantibody. Subsequent testing, including the use of gel column technology, ficin-treated cells, and antisera for phenotyping, showed the apparent cold autoantibody to be a red herring. Additional tube testing at immediate spin, 37°C, and indirect antiglobulin test (IAT) 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. <italic><bold>Immunohematology</bold></italic><bold>2014;30:117–120.</bold></abstract>

In an immunohematology reference laboratory, samples received for antibody identification react in many different ways requiring a variety of approaches. Sometimes, the clues from initial testing can lead to faulty assumptions and misdirection. Fortunately, a well-supplied reference laboratory will have access to a variety of techniques and reagents that, when used together, can reveal the true identity of the antibodies involved. We present a case of a patient sample with an apparent group AB, D+ blood type showing strong reactivity with all cells tested in the forward and reverse ABO, in the D testing as well as in a three-cell antibody screen. The initial assumption was that the plasma contained a cold autoantibody. Subsequent testing, including the use of gel column technology, ficin-treated cells, and antisera for phenotyping, showed the apparent cold autoantibody to be a red herring. Additional tube testing at immediate spin, 37°C, and indirect antiglobulin test (IAT) 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. Immunohematology2014;30:117–120.

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

Immunohematology

{"article-title":"A case of masquerading alloantibodies: the value of a multitechnique approach"}

In an immunohematology reference laboratory, samples received for antibody identification react in many different ways requiring a variety of approaches....

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

Article Category: Educational Forum case report

Published Online: Dec 01, 2019

Page range: 117 - 120

DOI: https://doi.org/10.21307/immunohematology-2019-105

Keywords
ABO discrepancy, cold autoantibodies, gel column technology, ficin, alloantibodies

© 2014 P.M.S. Wennersten et al., published by Sciendo

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

Article Category: Educational Forum case report

Published Online: Dec 01, 2019

Page range: 117 - 120

DOI: https://doi.org/10.21307/immunohematology-2019-105

KeywordsABO discrepancy, cold autoantibodies, gel column technology, ficin, alloantibodies

© 2014 P.M.S. Wennersten et al., published by Sciendo

Keywords
ABO discrepancy, cold autoantibodies, gel column technology, ficin, alloantibodies