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859) The patient with blood bank testing results shown in Tables 1-3 has an antibody to which one of the following blood group antigen systems?

Front Type Back Type RhD Typing

anti-A anti-B A1 cells B cells Anti-D

0 4+ 4+ 0 4+

Antibody Screen Test Method

D C c E e K k Jk^a Jk^b Fy^a Fy^b M N S s Le^a Le^b Anti-human Globulin Check Cells

Cell I + + 0 0 + + + + 0 + 0 0 + 0 + + 0 2+

Cell II + 0 + + 0 0 + 0 + 0 + + 0 + 0 0 + 0 2+

Antibody Panel Test Method

Panel Cell D C c E e K k Js^a Js^b Jk^a Jk^b Fy^a Fy^b M N S s PEG-AHG Ficin Check cells

1 + + 0 0 + + + 0 + 0 + + + 0 + + + 0 0 2+

2 + + 0 0 + 0 + 0 + + + 0 + + 0 + + 1+ 2+

3 + 0 + + 0 0 + 0 + + + + + + 0 0 + 1+ 2+

4 + 0 + 0 + 0 + 0 + + + 0 0 + + 0 0 1+ 2+

5 0 + + 0 + 0 + 0 + 0 + 0 + + + 0 + 0 0 2+

6 0 0 + + + + + 0 + 0 + + 0 + 0 + 0 0 0 2+

7 0 0 + 0 + 0 + 0 + + + 0 + 0 + 0 + 1+ 2+

8 0 0 + 0 + 0 + 0 + + 0 + 0 + 0 + 0 2+ 3+

9 0 0 + 0 + + + 0 + + 0 + 0 0 + 0 + 2+ 3+

10 0 0 + 0 + 0 + 0 + 0 + + 0 0 + 0 + 0 0 2+

11 + 0 + 0 + 0 + 0 + 0 + 0 0 + + + 0 0 0 2+

Patient’s cells 0

Front Type	Back Type	RhD Typing
0	4+	4+	0	4+

Antibody Screen	Test Method
Cell I	+	+	0	0	+	+	+	+	0	+	0	0	+	0	+	+	0	2+
Cell II	+	0	+	+	0	0	+	0	+	0	+	+	0	+	0	0	+	0	2+

Antibody Panel	Test Method
1	+	+	0	0	+	+	+	0	+	0	+	+	+	0	+	+	+	0	0	2+
2	+	+	0	0	+	0	+	0	+	+	+	0	+	+	0	+	+	1+	2+
3	+	0	+	+	0	0	+	0	+	+	+	+	+	+	0	0	+	1+	2+
4	+	0	+	0	+	0	+	0	+	+	+	0	0	+	+	0	0	1+	2+
5	0	+	+	0	+	0	+	0	+	0	+	0	+	+	+	0	+	0	0	2+
6	0	0	+	+	+	+	+	0	+	0	+	+	0	+	0	+	0	0	0	2+
7	0	0	+	0	+	0	+	0	+	+	+	0	+	0	+	0	+	1+	2+
8	0	0	+	0	+	0	+	0	+	+	0	+	0	+	0	+	0	2+	3+
9	0	0	+	0	+	+	+	0	+	+	0	+	0	0	+	0	+	2+	3+
10	0	0	+	0	+	0	+	0	+	0	+	+	0	0	+	0	+	0	0	2+
11	+	0	+	0	+	0	+	0	+	0	+	0	0	+	+	+	0	0	0	2+
Patient’s cells																		0

Rh. Kell. Kidd. Duffy. MNS.

Show Diagnosis/Topic

• Some Kidd antibodies can bind complement, leading to intravascular hemolysis.

• Kidd antibodies are dangerous because they have a tendency to drop to undetectable levels in plama. Thus, pretransfusion testing can miss the presence of a Kidd antibody and subsequent exposure results in a strong an amnestic response.

• Red cells that are homozygous for an antigen may react more strongly with a particular antibody than red cells that are heterozygous for the antigen (as demonstrated by the panel in this question). This effect is termed the dosage effect and is typically observed with antibodies to the Rh, MNS, Kidd, Duffy, and Lutheran blood group systems.

• The Kidd antigens are located on a membrane protein responsible for urea transport.

• After the ABO and Rh systems, antibodies to antigens of the Kell blood group system are the most common and are commonly associated with hemolytic transfusion reactions and hemolytic disease of the fetus and newborn.

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Antibody Screen																		Test Method
	D	C	c	E	e	K	k	Jk^a	Jk^b	Fy^a	Fy^b	M	N	S	s	Le^a	Le^b	Anti-human Globulin	Check Cells
Cell I	+	+	0	0	+	+	+	+	0	+	0	0	+	0	+	+	0	2+
Cell II	+	0	+	+	0	0	+	0	+	0	+	+	0	+	0	0	+	0	2+

Antibody Panel																		Test Method
Panel Cell	D	C	c	E	e	K	k	Js^a	Js^b	Jk^a	Jk^b	Fy^a	Fy^b	M	N	S	s	PEG-AHG	Ficin	Check cells
1	+	+	0	0	+	+	+	0	+	0	+	+	+	0	+	+	+	0	0	2+
2	+	+	0	0	+	0	+	0	+	+	+	0	+	+	0	+	+	1+	2+
3	+	0	+	+	0	0	+	0	+	+	+	+	+	+	0	0	+	1+	2+
4	+	0	+	0	+	0	+	0	+	+	+	0	0	+	+	0	0	1+	2+
5	0	+	+	0	+	0	+	0	+	0	+	0	+	+	+	0	+	0	0	2+
6	0	0	+	+	+	+	+	0	+	0	+	+	0	+	0	+	0	0	0	2+
7	0	0	+	0	+	0	+	0	+	+	+	0	+	0	+	0	+	1+	2+
8	0	0	+	0	+	0	+	0	+	+	0	+	0	+	0	+	0	2+	3+
9	0	0	+	0	+	+	+	0	+	+	0	+	0	0	+	0	+	2+	3+
10	0	0	+	0	+	0	+	0	+	0	+	+	0	0	+	0	+	0	0	2+
11	+	0	+	0	+	0	+	0	+	0	+	0	0	+	+	+	0	0	0	2+
Patient’s cells																		0

Clinical Pathology: General Principles, Hematology & Coagulation, Transfusion Medicine

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