Case report: reporting anti-G as anti-C+D may have misleading clinical implications.
Four months after a D- male was transfused with four units of D- red blood cells (RBCs), the results of a standard pretransfusion antibody screen and alloantibody identification panel detected anti-C+D in his serum. This report was interpreted by his physician to be evidence of alloimmunization to the D antigen, which triggered concern that the patient had been transfused previously with D+ RBCs as the result of an error in blood typing or personal identification. After a review of hospital records failed to identify such an error, consultation with a reference laboratory technologist confirmed that the serologic reactions resembled those of anti-C+D but were also consistent with anti- C + anti-G. Additional testing confirmed that the reactions were due to anti-G, not anti-C+D. One of the four donors was identified to have the C+D- RBC phenotype, which is typically G+, thus identifying the stimulus for anti-G. Routine reporting of the detection of anti-C+D in the serum of D- people, without confirmatory testing or commentary about the possibility that anti-G may resemble anti-C+D, may mislead health care providers who are not familiar with the pertinent blood group serology.
Mosley
A L
AL
Department of Pathology, Georgetown University Medical Center, Washington, DC, USA.
Trich
M B
MB
Thomas
N C
NC
Sandler
S G
SG