Case A6: Elderly Patient With a Difficult Antibody Combination
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Contributed by: Carol Stanley, ART, Nanaimo General Hospital
HISTORY
Mrs. E.M. is a 77 yr. old female admitted with chest pain and anemia. She has been admitted several times over the previous year for investigation of chronic gastrointestinal bleeding.
- Pregnancies: 4
- Transfusion: 2 units of red blood cells transfused on each of three occasions over the previous year. The most recent transfusion was 4 months ago.
Initial pretransfusion testing results
Based on these results, an antibody investigation was done.
- Antibody identification (Panel 1)
- Antibody identification (Panel 2)
- Antigen phenotyping
- Antibody identification (Panel 3)
CASE SUMMARY AND QUIZ
After reviewing the case summary, consider these questions.
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Which antibodies were once classified as HTLA?
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With which types of diseases are null Chido and Rogers phenotypes associated?
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Since anti-Ch and -Rg are considered to be clinically insignificant, is it important to investigate and identify them?
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Has anti-Ch or anti-Rg ever caused a severe transfusion reaction?
FURTHER READING
Graphpad. Online tool for calculating p values
Westhoff CM, Sipherd BD, Wylie DE, Toalson LD. Severe anaphylactic reactions following transfusions of platelets to a patient with anti-Ch. Transfusion 1992 Jul-Aug;32(6):576-9. [ Medline ]