Manish Raturi and Savina Prasad
Background: Multiple alloantibodies in patients’ sera present with widely variable reaction strengths and matching patterns. Therefore, from an immuno-haematologists’ point of view, alloantibodies once detected in antenatal or pre-transfusion setting, must be confirmed for their specificity and clinical significance. Case report: We report herein the case of a 57-year old female patient admitted in our hospital with chief complaints of breathlessness and mild grade fever. She was a known case of Type II diabetes mellitus with endstage renal disease. Her requisition for one pint of packed red blood cell (PRBC) was received at our department for pre-transfusion compatibility test and subsequent issue of blood. During immunohematology work-up, her blood type was found to be B Rh D Positive. However, her sera showed incompatibility with random B Rh D positive PRBC units. Her indirect coombs test was positive. The reactivity pattern in an eleven cell identification panel (Biorad, Switzerland) showed variable pattern and suggested of antibody/s against E and c antigen specificity. We subsequently issued one B Rh D positive (E and c antigen negative) anti-human globulin cross-matched compatible PRBC to the patient. We also issued an antibody card for her future reference. Conclusion: Transfusion of phenotypically matched PRBC for the implicated E and c compared to that phenotypically matched for the standard ABO-D System could help save patient from adverse transfusion event/s. Knowledge of multiple alloantibodies can assist in selecting appropriate transfusion strategy for the patient/s. In addition, requisite skill and precision is always desirable when dealing with multiple allo-antibodies because they can directly influence patient’s clinical outcome.
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Journal of Blood & Lymph received 443 citations as per Google Scholar report
