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Pos DAT
Blood bank exam 2
Question | Answer |
---|---|
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 |