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Blood bank exam 2

Reasons for positive DAT autoantibody, alloantibody reacting w/donor cells, HDN, drug antibodies coating RBCs, complement on RBC, nonspecific immunoglobulins
Secondary causes of WAIHA SLE, lymphoproliferative disease
WAIHA test results DAT: positive, Serum:reacts with all cells including pts, Eluate: reacts with all cells, XM: incompatible
Treatment of WAIHA steroids, rituximab, IVIG, cytotoxic drugs, splenectomy
___________ adsorption if recently transfused Allogeneic
___________ adsorption if not recently transfused Auto
To XM for WAIHA, if complex specificity use 1. least incompatible 2. ABO/Rh compatible 3. In vivo XM
in CAS, what is the only protein on the RBC? C'
Primary CAS Chronic. Monoclonal prot w/ kappa light chains. Older pop with lymphoma, CLL, waldenstroms
What syndrome is associated with primary CAS? Raynaud's
Secondary CAS Acute. seen 2-3 wks post M. pneumonia infection. Polyclonal IgM w/normal kappa and lambda light chains
CAS lab results Backtype discrepancy. DAT: C' only, Serum:reacts w/ all cells @ RT, Eluate: no run, XM: incompatible at IS with all
CAS common specificity auto anti-I
PCH DAT (+) C' only. in children post viral infection (measles, mumps)
PCH is unique how? Biphasic IgG. IT fixes C' thru C9
Common antibody for PCH? Auto anti-P
Test for PCH Donath Landsteiner test
Drug dependent Drugs must be present for detection of antibody
Drug independent drug does not have to be present for reaction, it alters the rbc membrane
NIPA independent of antibody formation
Drug dependent 1st type Antibodies react with drug-treated cells---drug binds to RBC and antibody binds to drug only
Drug dependent 1st type list of drugs IV penicillin, piperacillin, 2nd & 3rd generation cephalosporins, isoniazid, chemo
drug dependent 1st type results DAT (+) IgG only, Serum: NR, Eluate: NR, XM:compatible
Resolution for 1st type drug adsorption incubate SC with drug. Add pt serum and elute---> positive means the drug was causing the problem
Drug dependent 2nd type Need only to have drug in serum
drug dependent 2nd type list quinidine, phenacetin,acetaminophen, 2nd and 3rd gen cephalosporins
drug dep. 2nd type results DAT: C' only, Serum =, Eluate =, XM: compatible
Resolution for drug sep 2nd type drug + pt serum then add RBCS = hemolysis or agg
NIPA Non specific proteins adsorb to RBC-----it is independent of antibody----serum reacts w/drug coated cells and elute does not
Drug independent mimics auto ab---will react with all cells---disappears after drug is stopped but takes several months
Drug ind. list A-methyl dopamide, L-Dopa, procainamide, NSAID, 2nd & 3rd ceph, chemo (fluarabine)
Austoimmune like
Created by: aenewsom7
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