Antibody Identification Cases

Anemia requiring transfusion - Positive antibody screen detected during type and screen

GI bleed, Hgb 7.2 g/dL - Positive antibody screen on current admission

Menorrhagia with symptomatic anemia, Hgb 6.8 g/dL - Positive antibody screen pre-transfusion

Pregnancy at 28 weeks, routine antibody screen - Positive antibody screen at 28-week prenatal visit

Sickle cell disease with acute chest syndrome - Routine antibody screen prior to exchange transfusion.

Post-surgical anemia after hysterectomy, Hgb 7.0 g/dL - Positive antibody screen during pre-surgical type and screen

Myelodysplastic syndrome with chronic transfusion dependence - Positive antibody screen. Additional antibody suspected.

Autoimmune hemolytic anemia in partial remission, now needing surgical transfusion - Crossmatch incompatible with random donor units

Severe anemia, Hgb 5.8 g/dL, LDH elevated, haptoglobin undetectable - Positive antibody screen. All crossmatches incompatible.

Anemia, Hgb 8.2 g/dL. Acrocyanosis in fingers and toes. Recently recovered from Mycoplasma pneumonia. - ABO discrepancy noted on reverse typing. Positive antibody screen.

Thalassemia major, chronic transfusion-dependent, Hgb 6.5 g/dL - All panel cells reactive at AHG. Previous antibodies (anti-C, anti-E) no longer detected.

Colon cancer, pre-operative type and screen for scheduled resection - Antibody screen negative, but crossmatch incompatible with 2 of 6 donor units tested. Antibody workup initiated.

Multiple myeloma on active multi-agent chemotherapy. Hgb 7.1 g/dL. - All panel cells and crossmatches reactive at AHG. DAT positive (IgG).

Hip fracture requiring surgical repair, Hgb 9.2 g/dL - Positive antibody screen with weak reactivity. Workup initiated.

Pregnancy at 32 weeks. Rh-negative mother. Received RhIg (RhoGAM) at 28 weeks per protocol. - Routine third-trimester antibody screen now positive.

Multiple myeloma (IgG kappa), serum total protein 11.2 g/dL, IgG 6,800 mg/dL. Hgb 7.8 g/dL. - Positive antibody screen. All cells appear reactive.

Elective hip replacement, Hgb 10.2 g/dL. Type and screen ordered. - ABO discrepancy: unexpected reactivity on reverse grouping with A1 cells

Chronic kidney disease on hemodialysis, Hgb 7.1 g/dL - Positive antibody screen with complex reactivity pattern. Multiple antibodies suspected.

Third trimester pregnancy, Hgb 9.8 g/dL. Routine prenatal antibody screen. - Positive antibody screen detected at IS phase during routine prenatal workup.

Anemia (Hgb 7.8 g/dL) developing 2 weeks after Mycoplasma pneumonia. Acrocyanosis noted in fingers. Elevated LDH and indirect bilirubin. - Positive antibody screen with pan-reactivity at IS phase. Positive autocontrol at IS. Cold agglutinin disease suspected.

Sickle cell disease (HbSS), acute vaso-occlusive crisis with symptomatic anemia, Hgb 5.4 g/dL - All panel cells reactive at AHG with negative autocontrol. New alloantibody suspected. Patient phenotype: Jsa+, Jsb-.