Transfusion Science III - Cold Haemolytic Disease

Question 1

List the laboratory testings for CHD

Answer 1

1. ABO and Rh(D) test at 37 degrees
2. Antibody screen strictly at 37 degrees
3. DAT with anti-IgG and anti-C3d separately
4. Test plasma with type O RBC with I positive, i negative cells and I negative, i positive cells
5. In case of auto anti-I, Titrate plasma with I positive group O RBCs at 4 degrees

Question 2

What are the classical results of CHD due to anti-I?

Answer 2

1. Anomalous group
2. DAT positive (anti-C3d: positive, anti-IgG:negative)
3. Panagglutinin positive antibody screen
4. Positive reaction with I positive O RBC
5. Negative reaction with i positive O RBC
6. Titration over 1000

Question 3

How to resolve panagglutinin reaction in CHD?

Answer 3

Perform test at strictly 37 degrees

Question 4

List the treatments for CHD

Answer 4

1. Avoid the cold and keep warm
2. Transfuse blood through blood warmer
3. Severe cases; periodic plasma exchange, corticosteroids, alkylating drug chlorambucil

Question 5

What does PCH stand for?

Answer 5

Paroxysmal Cold Haemoglobinuria

Question 6

Describe the Donath Landsteiner Test

Answer 6

1. Incubate serum with P positive cells for 30 minutes at 4 degrees
2. Incubate for 60 minutes at 37 degrees
3. Cell lysis occurs

Question 7

Describe pathogenesis of PCH

Answer 7

1. Antibody binds to RBCs in extremities in low temperatures
2. Complement activated
   3.Intravascular cell lysis when warmed up to 37

Question 8

What conditions are PCH associated with?

Answer 8

1. measles, mumps, and chickenpox, influenza, infectious mononucleosis in young adults

Question 9

How do we obtain accurate ABO group on CHD patients

Answer 9

1. sample in 37 degrees strictly,
2. Wash RBCs in saline at 37
3. Incubate plasma at 37 degrees