Microscopic Description -- 55 y/o Male with Drop in Hemoglobin Following Platelet Transfusion


TRANSFUSION REACTION WORKUP:

Pre-transfusion:

The patient was A positive on pre-transfusion ABO/Rh typing:

Forward Reverse Rh ABO/Rh
Anti-A Anti-B Cell A Cell B anti-D A POS
4+ - - 4+ 3+

His antibody screen was negative

Six hours Post-transfusion:

Urine hemoglobin was negative. Visual plasma hemoglobin (VISHGB) was negative. Posttransfusion ABO/Rh typing of the patient's serum showed a weakly positive reaction with A Cells.

Forward Reverse Rh
Anti-A Anti-B Cell A Cell B anti-D
4+ - w+ 4+ 3+

Direct Antiglobuin Test (DAT) showed weak positivity using polyspecific and anti-IgG reagents and microscopic positivity using anti-C3d.

Direct Antiglobulin Test

Polyspcific

anti-IgG

anti-C3d

1+ (weak)

1+

M

Rapid acid elution was performed on the postransfusion specimen. Antibody identification panel on the eluate showed anti A antibodies reacting at AGT(2+)

  Immediate Spin 37 IgG AGT
Group O Cell I - - -
Group O Cell II - - -
Group A Cell - - 2+
Group B Cell - - -

FINAL DIAGNOSIS




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