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Richards-Malcolm Course: Immunohematology Theory (MET2011)
Case 1 Yes the quality control results meet the acceptable performance criteria. The reagents react as expected when used. If a reagent does not give the expected results, the control must be repeated. If the results are still incorrect, the vial should be discarded and a new vial must be tested. The QC is done to test the quality and specificity of reagents. According to Median Diagnostics The reactivity of certain antigens on reagent red blood cells may diminish as the erythrocytes age and/or are exposed to temperature variations. Therefore, monitoring of reagent red blood cells is recommended to ensure that acceptable levels of erythrocyte antigen reactivity are present in each vial. Obtaining the expected results confirms the identity and relative potency of the ABO grouping reagents. Median Diagnostics(2007) Based on the results obtained for Anti-A the reaction with A1 cells showed agglutination and was graded 4+ this is homozygous and the genotype appears to be AA or AO, no reaction occurred with B cells. For Anti-B the reaction with B cells showed agglutination and was graded 4+ this is also homozygous and the genotype appears to be BB or BO, no reaction occurred with A1 cells. Case 2 1. Reaction of Bombay Phenotype Anti A 0 Anti B 0 Anti AB 0
The red cells do not agglutinate with anti-A. Anti-B or Anti-H (Ulex europaeus . which have the H antigen. The reagents might not have been stored properly(in appropriate condtions) . Reaction of Bombay phenotype A1 cells 4+ B cells 4+ O cells 4+ The Anti-H would be detectable in pre transfusion tests. their serum would agglutinate group O screen cells and group O donor cells. In the patients serum sample 4+ agglutination reaction will be seen for A1 cells. these reagents are not expected to be losing potency and specificity within 2 weeks. and their serum contain anti-A and anti-B and anti-H.If they require blood transfusion. Bombay people would be incompatible when crossmatched with red cells of all normal ABO groups (groups O. A and B antigens. 3. they must receive blood from another Bombay. Donors must be sought among their blood relatives (especially siblings) Case 3 1.In persons with Bombay phenotype their Red blood cells lack H.lectin) 2. B and AB). B cells and O cells. R2R2 DcE/DcE c is not present and is considered negative Case 4 From the results obtained it can be concluded that the reagents are losing potency. This might be because the reagents are contaminated or old. A.B and AB. The anti-H would not be detected in the ABO group therefore no reaction occurs with Anti A.
is a secretor). the Le-a antigen will be present in his bodily fluids and on his erythrocytes. Lewis antigens are components of exocrine epithelial secretions. . They are red cell antigens which are not produced by the erythrocyte itself. it is difficult to detect antigen Le-a because it is converted to Le-b very efficiently.Case 5 1. Instead. people with readily detectable Lewis a antigen are non-secretors. do not secrete A.e. Lewis negative people (Le a-.e. A weak D test should be performed next to solve the Rh typing discrepancy 3. Therefore. converting it to the Le-a antigen. No a weak D test should not be performed if the patient has a positive direct antiglobulin test (DAT). There are two main types of Lewis antigens. Lewis a (Le-a) and Lewis b (Le-b). In most people having both Le and Se. The result for the control should be negative and not positive no agglutination should be present because no reaction is to occur. adding fucose to the oligosaccharide precursor in terminal position. The combined action of the two enzymes will produce antigen Le-b. If a person besides Le has the allele Se (i. The patient should receive AB blood type Case 6 The patient is a secretor. In blood banking a negative control is normally used. The enzyme fucosyltransferase 3 encoded by Le gene adds a fucose to the precursor oligosaccharide substrate in sub terminal position. the exocrine cells will have also the enzyme fucosyltransferase 2. B or H antigens. If DAT is positive the weak D will also be positive because the antibody/protein that causes weak D to be positive are masking the red cell and we won’t know if its truly positive or negative 4. i. If a person has Le allele and is non-secretor (homozygous for the se allele). while Lewis b antigen is found only in secretors. and are subsequently adsorbed onto the surface of the erythrocyte. 2.
html Encyclopedia Briannica(nd)Lewis blood group system.Retrieved fromhttp://www.Le b-) are homozygous for the recessive le allele and can be either secretors or non-secretors.us/pdfs/BBQA%20II.mediondiagnostics.Retrieved from http://www.Blood Bank Quality Assurance II(BBQA II) Testing Reagents. Retrieved from.http://www.org/wiki/Lewis_antigen_system .d). (Lewis Antigen system n.pdf Bombay Phenotype(n.Retrieved fromhttp://en.ualberta.d) Case 7 References: Median Diagnostics(2007).britannica.ca/~pletendr/tmmodules/abo/70abo-oh.wikipedia.com/EBchecked/topic/338252/Lewis-blood-group-system Lewis Antigen System.