Cold autoantibody interference in pretransfusion testing and its resolution: a case report

Authors

  • Rabeya Yousuf Blood Bank Unit, Department of Diagnostic Laboratory Services, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
  • Hari Priya Raghvan Blood Bank Unit, Department of Pathology and Department of Diagnostic Laboratory Services, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
  • Nur Afifah Suhemi Blood Bank Unit, Department of Diagnostic Laboratory Services, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
  • Nor Fadzliana Abdullah Thalith Blood Bank Unit, Department of Diagnostic Laboratory Services, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
  • Yee Loong Tang Blood Bank Unit, Department of Pathology and Department of Diagnostic Laboratory Services, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
  • Suria Abdul Aziz Blood Bank Unit, Department of Pathology and Department of Diagnostic Laboratory Services, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia

DOI:

https://doi.org/10.3329/bjms.v23i4.76555

Keywords:

Cold autoantibody; pretransfusion testing; panagglutination, cold autoadsorption; dithiothreitol (DTT).

Abstract

We report a case of cold autoantibody detected in a 69-year-old gentleman diagnosed with chronic lymphocytic leukemia and cold autoimmune hemolytic anaemia. Pretransfusion testing showed panagglutination in ABO grouping, antibody screening and identification, with positive direct antiglobulin test (DAT) and positive control cells. A cold autoantibody was suspected, however, the test using a prewarm method and washed RBC with warm saline failed to resolve it. Further tests using DTT-treated cells resolved the grouping as AB RhD positive and DAT as positive with anti-C3d only (control negative). Cold autoadsorption was done and repeated antibody screening using cold-autoadsorped plasma was negative, excluding the presence of alloantibody. The cold-agglutinin titer was >1028 having a wide thermal range. Crossmatching using cold autoadsorped plasma with the AB-positive donor blood was compatible and the patient was transfused safely. For such cold autoantibody cases, an extensive immunohematological workup is required to exclude underlying alloantibody for transfusion safety and efficacy.

Bangladesh Journal of Medical Science Vol. 23 No. 04 October’24 Page : 1238-1242

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Published

2024-10-02

How to Cite

Yousuf, R., Raghvan, H. P., Suhemi, N. A., Abdullah Thalith, N. F., Tang, Y. L., & Aziz, S. A. (2024). Cold autoantibody interference in pretransfusion testing and its resolution: a case report. Bangladesh Journal of Medical Science, 23(4), 1238–1242. https://doi.org/10.3329/bjms.v23i4.76555

Issue

Vol. 23 No. 4 (2024)

Section

Case Reports

License

Copyright (c) 2024 Rabeya Yousuf, Hari Priya Raghvan, Nur Afifah Suhemi, Nor Fadzliana Abdullah Thalith, Yee Loong Tang, Suria Abdul Aziz

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