Mrs. E.M., a 77 yr. old female, was admitted with chest pain and anemia. She had been admitted several times over the previous year for investigation of chronic gastrointestinal bleeding. She had four prior pregnancies and was transfused with two units of red blood cells on each of three occasions over the previous year.
ANTIBODY SCREEN AND CROSSMATCH RESULTS
- Group A Rh positive
- Antibody screen positive by PEG-IAT (all 3 screen cells)
- Autocontrol negative
- Three panels (including one by enzyme-IAT) confirmed anti-E
- Serological pattern of a high incidence co-existing alloantibody suggested possible anti-Ch or -Rg
- Panel results and antigen phenotyping could not exclude anti-K
- Rh positive (probable R1r) K- Fy(a+b+) Jk(a+b+) M-N+ S+s+
- Antigen typing was possible as last transfusion occurred 4 months ago.
- Due to the urgency of the request, two units of A Rh positive E- K- RBC that were compatible by PEG-IAT were transfused without incident.
- Canadian Blood Services later confirmed the presence of anti-E and anti-Ch.