Case Study 3: Narrowing the Possibilities

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The page below is a sample from the LabCE course A Comprehensive Overview of "HTLA" and "HTLA-Like" Antibodies. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Case Study 3: Narrowing the Possibilities

Now that it is known that the antigen is resistant to enzyme treatment and sensitive to 0.2M DTT treatment, the reference laboratory listed the most common possibilities and performed a select cell panel with rare cells negative for those antigens. This selected cell panel is especially created when there is a concern of increased red cell clearance or suspected "HTLA" antibody of clinical relevance.
Strength of initial reactivity and the ethnicity of the patient were also taken into account to further narrow the initial possibilities—this is done in order to reduce waste of limited rare red cells.
  • Most commonly seen high-prevalence antigens that are resistant to enzymes and sensitive to DTT treatment:
    • Ch, Rg, Kna, McCa, Yka, Yta, VEL, k, Kpb, Jsb, Sc:1, Lwa, Hy, Joa, Gya, Lub
  • Most commonly seen high-prevalence antigens more commonly negative in Caucasian people that exhibit a near consistent reactivity pattern:
    • Yta, VEL, k, Kpb, Lub
    Rh-HrKellDuffyKiddLewisMNSsP1LutheranXgRarity
    Cell NumberDCcEeVCwKkKpaKpbJsaJsbFyaFybJkaJkbLeaLebMNSsP1LuaLubXgaAHG
    1+++0+000+0+0+0++++0+++++0++Yt(a-) 0√
    2++00+0+++0+0+++0+0+0++++0++VEL- 1+
    3+0++000+00+0+0+++0++00++0++k- 1+
    4+0+++000++00+++++0++++++0+0Kp(b-) 1+
    5+++0+000+0+0++++++00+++0+0+Lu(b-) 1+