Panel Case Studies

Correct interpretation of panel studies requires practice. The following case studies will illustrate a systematic method of evaluating and determining the specificity of the antibody present. Remember, antigens are present on the red blood cells. A positive reaction with a cell indicates the presence of an antibody in the patient sample directed against an antigen present on the reagent cells. Careful evaluation of the positive and negative reactions will frequently indicate the specificity of the antibody.

An excellent overview of the process is illustrated in this presentation created by Renee Wilkins, PhD, MLS(ASCP)cm from the University of Mississippi Medical Center.

Crucial to the investigation of the antibody is the patient’s history:

• Has the patient ever been pregnant? Pregnancy can cause immunization of the patient to an antigen on the fetus cells that the mother lacks and which was inherited from the father.
• Has the patient ever been transfused? Transfusion exposes the patient to RBC antigens they do not possess and can cause immunization to antigens they lack but are present on the donor RBCs.
• What is the patient’s diagnosis? This may offer clues as to the patient’s exposure to RBC antigens. Perhaps the patient has sickle cell anemia, a frequently transfused population, perhaps the patient is pregnant or the diagnosis may be of little use as it may be something like “weakness”.
• What medications is the patient taking, here in the hospital and at home? This information is only useful if the autocontrol and DAT on the patient is positive.

Instructions

1. Print out the panel for each case study (1st page of each document only).
2. Review the patient history.
3. Follow the instructions carefully for evaluating the panel.
4. Write down any questions you may have for your professor.
5. Evaluate the practice panels. If you cannot correctly identify the specificity of each antibody, meet with your professor for additional assistance.
   • Panel Case Study 1
   • Panel Case Study 2
   • Panel Case Study 3