Time for another
BTLP-TACT exercise. I was presented with two cases
21906 – a fifty
two year old woman in A&E requiring group & save for epistaxis.
She
grouped as B Rh(D) Positive with antibody screen positive in cells 1 and 3.
I
requested antibody panels. The IAT panel was positive in cells 1, 3, 6, 9 and
10 which corresponded with anti Fy(a) but did not rule out anti-Cw or anti-
Lu(a). The enzyme panel was negative throughout which in reality did NOT rule out
anti-Cw, but for the sake of the exercise did rule out anti-Cw.
Does this
rule out anti-Lu(a)… one way to find out (!) I said it did not rule out
anti Lu(a)
It might
help if anti-Lu(a) appeared in the screening antigram
50961 – an
eighty-two year old chap in the urology out patients department requiring group
& save as a pre operative precaution.
His cell
group was B, but serum group was not. As the control was not positive I assumed
the Rh group result was valid. Was it?
I went with
“indeterminate Rh(D) Negative”
The
antibody screen was positive in cells 1 and 2. I requested antibody panels. Both
the IAT and enzyme panels were positive in cells 1,2 and 3 which corresponded
with anti-D but didn’t rule out anti-Cw
I got the green
light…. SO – a negative result in enzyme in the simulator DOES NOT rule out anti-Lu(a).
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