Case A6: Elderly Patient With a Difficult Antibody Combination
Contributed by: Carol Stanley, ART, Nanaimo General Hospital
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.
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.
Which antibodies were once classified as HTLA?
With which types of diseases are null Chido and Rogers phenotypes associated?
Since anti-Ch and -Rg are considered to be clinically insignificant, is it important to investigate and identify them?
Has anti-Ch or anti-Rg ever caused a severe transfusion reaction?
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 ]