A case report of multiple Rh alloantibodies in a pregnant female: Resolution by sequential adsorption

• Published in: Asian journal of transfusion science Vol. 15; no. 1; pp. 109 - 112
• Main Authors: Setya, Divya, Tiwari, Aseem, Arora, Dinesh, Mehta, Swati, Aggarwal, Geet
• Format: Journal Article
• Language: English
• Published: Ahmedabad Wolters Kluwer India Pvt. Ltd 01.01.2021; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Wolters Kluwer - Medknow; Wolters Kluwer Medknow Publications
• Subjects: Adsorption; antenatal; anti-g; Antibodies; Antigen-antibody reactions; B cells; Blood transfusions; Case Report; Case reports; elution; Females; multiple alloantibodies; Obstetrics; Pregnancy; Pregnant women; rare donor; sequential adsorption; Serology; Viral antibodies; elution; multiple alloantibodies; sequential adsorption; anti-G; rare donor; Antenatal
• ISSN: 0973-6247; 1998-3565
• DOI: 10.4103/ajts.AJTS_101_19

Anti-G antibody mimics the reactivity pattern of coexistent anti-D and anti-C. Differentiating between the two is significant in antenatal females where the decision to administer RhD prophylaxis is based on the presence or absence of anti-D antibody. The aim of reporting this serological challenge is to emphasize the need for phenotyping red cells for sourcing appropriate in house red cell reagents and to help transfusion services sharpen problem-solving skills. A 26-year-old pregnant female with a complicated obstetric history and a positive indirect antiglobulin test presented to the hospital for antenatal assessment at 24 weeks. A positive antibody screen warranted identification of the implicating antibodies. Since identification was suggestive of multiple alloantibodies whose specificities could not be confirmed, step-wise sequential adsorption and elution was required. Anti-D, anti-C, and anti-E antibodies were identified in patient plasma with titers of 1024, 4, and 32, respectively. The absence of anti-G was also confirmed. Multiple alloantibodies can pose a challenge to transfusion services. However, with the help of select cells, phenotyping, adsorption elution studies, and phenotyped donor units; solving complex serological cases can be accomplished.