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36 Cards in this Set
- Front
- Back
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AHG
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causes cell agglutination of previously sensitized cells.
sensitized = complement or antibodies are on the rbcs |
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polyspecific AHG
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has anti-IgG fraction and anti-C3d fraction
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anti-IgG
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monoclonal has specific antibodies that react only with gamma heavy chains
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anti-complement
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reactive against C3b and C3d but no human immunoglobulin activity
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antiglobulin test
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tests the rbcs to see if they are sensitized by IgG antibody, complementor both either in vivo or in vitro.
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DAT
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detects in vivo sensitization (in body)
used to detect HDN Autoimmune hemolytic anemia Transfusion reactions Drug-induced hemolytic anemia |
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IAT
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detects in vitro sensitization (in tube)
used to detect antibody detection and identification compatibility testing antigen phenotyping titration |
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agglutination of coombs control cells confirms
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AHG reagent was added
AHG was active AHG was not neutralized |
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ABO antisera does not require AHG because..
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ABO is IgM
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positive controls test
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sensitivity
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negative controls test
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specificity
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IAT pos DAT pos
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Invalid. Pos DAT means cells were sensitized in vivo and will agglutinate at IAT
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wiener genetic theory
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current Rh genetic theory: two loci
two closely linked genes: RHD and RHCE so close that crossing over is extremely rare |
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RHD
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codes for the presence of absence of D/d
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RHCE
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adjacent to RHD locus
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Rh Antigens
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well developed at birth
found on RBC membrane only genetically controlled |
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D antigen
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most immunogenic
Rh type is determined by the presence or absence of D 85% of the population is Rh pos |
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weak D antigen
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weakend form of the D antigen
caused by position effect of other Rh genes on the D antigen- When C is trans position to D inheritance of fewer number of D antigen sites |
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weak D testing is done on
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pregnant women
donors Rh neg newborns whose moms are also Rh neg |
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weak D test
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IAT using AHG
Albumin control |
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f antigen
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present whenever c and e are in cis position (same side)
ie. CDe/cde or CDE/cDe |
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G antigen
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present when D or C are present
anti-G mimics anti-D or anti-C |
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D deletion
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rare people who inherit no Ee or Cc
lack of Ee most common lack of both called dash D dash (-D-/-D-) |
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IgM anti-D
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also called Saline anti-D will cause agglutination of saline suspended rbc
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general characteristics of Rh antibodies
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pregnancy or transfusions
immune IgG warm IAT/high protein media enhanced by enzymes cannot activate complement all are clinically significant |
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inadequate washing will create a false
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neg because free globulin will neutralize the AHG before it can react with the ab on the rbc
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fractionating IgG/C3d
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neonates only worry about IgG
adults must fractionate. C3d will not elute from cells |
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most common warm auto antibody
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Rh blood group
CcEeDd |
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most common cold auto antibody
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anti- I
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Rh control
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provided by the manufacturer and contains all the additives and potentiators present in the antisera (anti-D reagent) but LACKS ANTI-D.
rules out polyagglutination and in vivo sensitization |
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what do the differences in reactivity at 37 adn IAT indicate
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if there are multiple antibodies they may react differently at different phases
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mixed field reactions caused by
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contamination of reagents
anti-Sda weak subgroup of A (A3) given intergroup transfusion bone marrow transplant |
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screening cells requirements
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o cells
at least 2 sets known phenotype homozygous antigens best ag's must have good reactivity and known antigen strength not expired |
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LISS
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decreases ionic strength
increases antibody uptake |
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Partial D (mosaic)
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D antigen is made up of 9(4?) parts. mosaic people are missing one or more of those and can develop an antibody to the piece they lack
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Rh control
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used to asses the validity of high protein Rh typing reagents. High protein diluents may cause false positives due to spontaneous agglutination of cells coated with immunoglobulin in vivo
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