Unexpected Anomaly

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The page below is a sample from the LabCE course The Disappearing Antibody: A Case Study. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Unexpected Anomaly

3. Do the results of the initial antibody screen (shown below) support the presence of the identified antibody?
CellRh-HrKellDuffyKiddLewisLutheranPMNSsXg

Rh DCcEeCwKkKpaJsaFyaFybJkaJkbLeaLebLuaLubPMNSsXgaGel IAT
1R2R2+0++000+00+0+0+00+++++++3+
2R1R1++00+00+000+0+000+++0++02+
3rr00+0+0++00+0+00+++00+0+02+
No: All 3 screen cells reacted in the initial screen. Upon review, however, only Screen Cells 1 and 3 were Jk(a+); Screen Cell 2 reacted but was Jk(a-).
A reference laboratory investigated this anomalous result. It was discovered that the patient had anti-Rd, an antibody to the low-frequency antigen radin (Rd). By chance, Screen Cell 2 was Rd-positive. Radin has a frequency of less than 0.5% in several populations tested.
If the screen cell manufacturer were notified, they would likely confirm that the cell was Rd-positive, inform their clients, and document it in future antigrams.