title: Antibody screening in multitransfused patients: a prerequisite before each transfusion.
abstract: Life-long red blood cell (RBC) transfusions remain the main treatment for severe thalassemia. We hereby report a case of anti S and anti Lu(a) in a β-thalassemia major patient detected incidentally on antibody screening. The patient was a known case of β-thalassemia major and was on regular blood transfusion every 3 weeks from the institute from the age of 6 months. Subsequently, on one occasion, patient's crossmatch was compatible despite positive antibody screen using microcolumn gel technique. Autocontrol and direct antiglobulin test were negative on microcolumn gel. Anti S and anti Lu(a) antibodies were identified. Blood unit found compatible was negative for S and Lu(a) antigens. Antibody titers were 1:1 for both anti S and anti Lu(a) in AHG phase using tube technique and antibodies were of IgG type. Blood unit was transfused uneventfully to the patient. Donors were traced back (last three donations) and called for repeat blood sample testing for S and Lu(a) antigen. Two out of three donors were found to be S antigen positive and one out of these two was Lu(a) antigen positive. Anti S and anti Lu(a) antibodies were again identified on patient's subsequent visit for transfusion. The present case re-emphasize the importance of antibody screening at each visit in earlier detection of antibodies in multi transfused patients. Encouraging patients to receive transfusion from one center and dedicating donors could reduce alloimmunization rate but larger studies are required.
authors.affiliation: Department of Transfusion Medicine, Government Medical College and Hospital, Chandigarh, India.
authors.forename: Divjot S
authors.initials: DS
authors.lastname: Lamba
authors.affiliation: Department of Transfusion Medicine, Government Medical College and Hospital, Chandigarh, India. Electronic address: drkmittal@gmail.com.
authors.forename: Kshitija
authors.initials: K
authors.lastname: Mittal
authors.affiliation: Department of Transfusion Medicine, Government Medical College and Hospital, Chandigarh, India.
authors.forename: Tanvi
authors.initials: T
authors.lastname: Sood
authors.affiliation: Department of Transfusion Medicine, Government Medical College and Hospital, Chandigarh, India.
authors.forename: Ravneet Kaur
authors.initials: RK
authors.lastname: Bedi
authors.affiliation: Department of Transfusion Medicine, Government Medical College and Hospital, Chandigarh, India.
authors.forename: Paramjit
authors.initials: P
authors.lastname: Kaur
authors.affiliation: Department of Transfusion Medicine, Government Medical College and Hospital, Chandigarh, India.
authors.forename: Gagandeep
authors.initials: G
authors.lastname: Kaur
mesh_terms: D001782:Blood Donors; D015815:Cell Adhesion Molecules / Q000097:blood* / Q000276:immunology; D002675:Child, Preschool; D046148:Donor Selection; D017707:Erythrocyte Transfusion; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood* / Q000276:immunology; D007518:Isoantibodies / Q000097:blood* / Q000276:immunology; D008188:Lutheran Blood-Group System / Q000097:blood* / Q000276:immunology; D008297:Male; D017086:beta-Thalassemia / Q000097:blood* / Q000276:immunology / Q000628:therapy*
chemical_list: C090228:BCAM protein, human; D015815:Cell Adhesion Molecules; D007074:Immunoglobulin G; D007518:Isoantibodies; D008188:Lutheran Blood-Group System
keywords: Alloimmunization; Antibody screening; Blood transfusion; Erythrocyte antigens; Thalassemia