1. A 32-year-old woman was admitted to the hospital with acute gastrointestinal
ID: 243369 • Letter: 1
Question
1. A 32-year-old woman was admitted to the hospital with acute gastrointestinal bleeding. Her hematocrit was 0.16 (16%) (reference range 0.33-0.43 [33%-43%). Pretransfusion testing shows that the patient was group O, Rh positive and the antibody screen was negative. The transfusion service had no record for this patient and five units of ABO-compatible RBCs were issued with abbreviated compatibility testing. After transfusion of the fifth unit, the patient suffered an immediate hemolytic transfusion reaction, and a posttransfusion blood sample was sent to the transfusion service for investigation. Laboratory data are shown as follows Laboratory Data. Patient's Results Tests ABO Grouping Forward Anti-A Anti-B Reverse Ai cells B cells Rh Grouping Anti-D Rh Control Antibody Screen RBCI RBC II MF Direct antiglobulin test Results of an antibody identification panel performed on the patient's posttransfusion serum and on an eluate from the patient's posttransfusion RBCs are shown in the attached worksheet. 1. What is the most likely explanation for the patient's posttransfusion positive direct antiglobulin test result? 2. What are the most likely antibody specificities in the posttransfusion serum? 3. What is the specificity of the antibody in the eluate? . What is the most likely cause of the transfusion reaction? 5. What further testing could be performed? (3 marks (6 marks) (6 marks) (2 marks) (3 marks)Explanation / Answer
Hemolytic reaction occurs when wrong blood units transfusion.when group A red cells given to O group IgG and IgM antibody form destroys it own cells results in hemolytic reaction .
Test :
blood sample from the patient and transfusion sample to check antibodies.
Fibrin degradation product test
Haptoglobulin
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