Answer Happy

Compatibility Case Study A 6-month-old black male presented to the pediatric emergency at Children's Hospital with complaints of progressive pallor and yellowish discoloration of sclera for the past 2 weeks. Hepatosplenomegaly was absent after a physical exam, and no history of any previous blood transfusion was present. Biochemical parameters showed mild indirect hyperbilirubinemia. Hematological findings showed a hemoglobin of 5g/dL with an elevated reticulocyte count. After a blood sample was drawn, the patient's blood type was found to be A positive, on a forward and reverse type at room temperature. During the crossmatch, multiple units of packed RBCs were found to be incompatible. A full work-up was then performed on the patient. Extended blood grouping was done at three temperatures; 4°C, 22°C, and 37°C. After this testing, the patient's blood group was confirmed to be A positive. A Direct Coombs test was performed using a gel card (Figure 1a). Further Direct Coombs tests show that the patient had the presence of IgG (Figure 1b). An Indirect Coombs test was then performed. An antibody screen using a gel card was run at 37°C (Figure 1c). An antibody ID was then run (Panel 1). Then, a further Rh-Kell extended antigen profile was done (Figure 1d). 1) What is the interpretation of the DAT gel card? 2) What is the interpretation of the IgG gel card? What is the importance of this card and what does it imply? 3) What is the interpretation of the Antibody Screen? 4) What is the most probable antibody on the Antibody ID? 5) What is the interpretation of the Rh-Kell gel card? ) 6) What is the determined diagnosis for this patient?
cti DAT A.CH IgG IgA IgM IgM C3c C3d cti b a rabbit monoclonal 2 2 2 3 С с E e K cti с d
ALBAcyte®REAGENT RED BLOOD CELLS FOR IDENTIFICATION OF UNEXPECTED ANTIBODIES Antibody Identification (16-Cell) REF 2473U QUOTIENT le month black male Name: Patient Sample Details Sample Identification: D.O.B ABO Rh: At Lot No: V243680 Diagnosis History: Hospital: DAT Anti-IgG Anti-C3 Expiry Date: 2022.02.28 U.S License 1807 2 1 3 + 0 4 5 6 7 IT - Rh-hr Kell Duffy Kidd Lewis MNS P Lutheran Additional Antigens TEST RESULTS Cell #Rh-hi -hr Donor DCECOCK K KPKpus UFFY JK JK" Le'le' MNS P1 "LU" Xgwr Special Types IS 31 AM CL Cells 1 R. "R, 2788020121445-00AONTOOOOOOOOOO0+0000 +2 +3+3 RR 1179123 00 ONTO 0+0+0+0+DOO + 0 +31 +3+3 2 RR 401250205032OOOOOO0+ 0 + -ODOO 0.00 ololo 3 3 1095603 00NT0-0000000000 ++2 +2 4 rr 3097391 00NT OO0+0+0+0+0000 +2+23- 5 6 Ror 3022950 OONT 000 + +000.000 0 0 + 0 + + +10 +3+3 6 7 1308853 OOONTOOOOOOOOOOOOO 00+ 0+ 0 +2+3+3 7 8 10330827 00000000000 +++ II +0 6170686 +2 +2+3 000-0000-00000000 +3 +3 13 9 10 51719020 OOONO 0+0++000E+0+00 +2+3+3 10 RR, 50705293 HOONTOO +0+ RiR 11068269 AOOOONTOOOOOO 12 +2131 +POOOOOOOO +3+3+3 12 Rir 14511885 ONT 0000000000-000 13 14 R R +3+3+3 - 27680201824870 OONTOOOOOOOOOOOOOOOOOOOO OOO2 이아 14 15 R R 55196991 OOONT 0000 T+000000 0 01. OOO +3 15 16 52245285 000AANTOO00+0000 0+1+0+0+1+0+ 3-35 Patients cells 8 IT 9 8 IT 11 12 11 13 rr "O 0 0 16 Conclusions/Further Testing Required: Notes: 1. All cells are DAT negative. 2 's strong reactor, Wweak reactor, NT = not tested 3. The antigen status has been determined presumptively 4. Cell 6 is designated as Rus but the phenotyping test results cannot exclude the possibility of the red blood cell genotype being R.R * Indicates those antigens whose presence or absence may have been determined using only a single example of a specific antibody Quotient, 301 South State Street, S-204, Newtown, PA 18940, USA Product Technical Support Tel: 1-888-228-1990 Web: www.quotientbd.com Signature/Initials: Date: Z473U/P1/02