September 2014 - Presented by Sarah Barnhard, M.D., Transfusion Medicine Fellow

Clinical History:

The patient is a 24-year-old O RhD positive G2P1 female at full term in her pregnancy.  Her history includes HbSC disease and she has had sickle cell pain crises episodically requiring transfusions.  Fetal monitoring has been stable.

She had three previously identified red cell alloantibodies (anti-E, anti-C, and anti-S), and her full warm phenotype revealed she lacks the K, C, E, Duffy-a, Duffy-b, Kidd-b, and S antigens.  She has therefore been provided with red cells lacking the following red cell antigens for her needs: K, C, E, Duffy-a, Kidd-b, and S.

A type and screen revealed reactivity in both cells and an antibody panel showed strong polyagglutination (the auto control was negative).

Discussion Questions:

  1. What does this initial finding suggest?

  2. What further testing would be warranted in this case?

  3. What test could be performed to assess the clinical significance of any additional red cell alloantibodies?