At the
weekend I had an interesting case. Two samples from the same patient which the
analyser grouped both as “A”, but with an indeterminate Rh group. I performed the
groups (both long groups and check groups) and made both A Rh(D)
Negative. But I looked closely at the analyser plots. Was there something in
there?
The standard
operating procedure says that the anti-D reagent should be used
macroscopically, but under the microscope was some very small agglutinates.
Reference
to SPI-CE came up with the patient who had been tested from another hospital.
They were known to have a weak Rh(D). A *very* weak Rh(D).
Now… had
there been analyser failure and had I been working using manual techniques I
would have called this patient Rh(D) negative. For a transfusion point of view
this would have been fail-safe as I would have transfused Rh(D) negative blood.
However if this had been an ante-natal patient I might have issued anti-D.
I’ve been
fretting about this…
There’s
more on weak D and D variants that you can read by
clicking here…
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