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Case Based Learning and Textbook Chapter Review SessionFebruary 1, 200

!o""ison Chapter # – ABO, P, Lewis, Ii$$BB Te%hni%a" !anua" Chapters 1& – ABO, H, and Lewis Blood Groups and structurally relatedantigens

Note: please substitute text o your c!oice or "ollison

Cases

#$ %# year old &ale wit! diagnosis o Non'Hodg(in)s Ly&p!o&a was ad&itted to He&atology in ateac!ing !ospital$ *wo &ont!s ago !e was transused wit! + units o AB ! positi-e blood orsy&pto&atic ane&ia as an outpatient in anot!er acility$ *!e transusion was une-entul$ *en daysprior to !is current ad&ission, !e was transused again wit! # unit o AB positi-e red cells$ Hede-eloped a !e&olytic transusion reaction$ *!e patient was subse.uently transerred to a teac!ing!ospital$ On ad&ission, t!e patient)s Hb was /0 g1L$ *wo units o pac(ed red cells were ordered$

2orward Grouping e-erse Grouping

 Anti'A Anti'B Anti'AB Anti'3 A cell B cell O cell

45 45 45 45 +5 Neg Neg

6!at is t!e patient7s blood group8 6!at ot!er in-estigations would you order8

9o&&ent on urt!er &anage&ent o t!is patient$

+$ %+ year old A'!'pos &ale wit! te-ens';o!nson syndro&e was ad&itted to I9it ell to ?4 g1L / days later$ *o correct ane&ia, !e was gi-en # unit o A pos i&&ediate'spincross&atc! co&patible pac(ed B9 @9" was peror&ed wit! pre'I=IG seru&$ Ater C cc wereinused, patient7s blood pressure dropped to /C14C &&Hg$ *ransusion was !alted$ Hb was /+ g1L and!is L3H and bilirubin were ele-ated +x abo-e upper li&it o nor&al$

6!at urt!er in-estigations would you order8

9o&&ent on urt!er &anage&ent o t!is patient$

%$  / year old A'!'pos e&ale was ad&itted to !ospital wit! bris( GI bleeding$ Ad&ission sa&plere-ealed a negati-e antibody screen$ !e was transused % units o B9 on t!e day o !er ad&ission@3ec +0 and urt!er + units 4 days later @3ec %#$

 A new blood ban( sa&ple was re.uested on ;an 4$ Her antibody screen was positi-e and 3A*negati-e$ Panel was consistent wit! an anti';(a$ Between ;an 4 and ;an #0, s!e recei-ed #+ B9, +22P, + pools o 3P and # ap!eresis platelet$

*esting on ;anuary #D, re-ealed a positi-e antibody screen, AHG cross&atc! wit! ;(a negati-e units+ out o % positi-e and 3A* positi-e wit! IgG$

6!at urt!er in-estigations would you li(e to peror&8

6!at do you t!in( is going on8

9o&&ent on urt!er &anage&ent o t!is patient$

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8/9/2019 TMR Case for 2008-02-01

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4$ 4? year old &ale wit! I*P was transerred ro& a perip!eral !ospital to a teac!ing !ospital or urt!er&anage&ent$ *reat&ent in t!e perip!eral !ospital included I=IG @C$4&g1(g or 4 days and a pool o 3P$ On ad&ission to a teac!ing !ospital !e recei-ed urt!er I=IG #g1(g or t!ro&bocytopenicbleeding$ Ad&ission blood ban( tests were as ollows: antibody screen @"* negati-e, 3A*negati-e$

2orward Grouping e-erse Grouping

 Anti'A Anti'B Anti'AB Anti'3 A cell B cell O cell

45 C N1A 45 %5 45 N1A

6!at urt!er in-estigations would you li(e to peror&8

6!at do you t!in( is going on8

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