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  • #16
    really its very good and interesting sharing
    i hope if its repeat in all over specialities in the lab.

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    • #17
      المشاركة الأصلية بواسطة medical lab specialist مشاهدة المشاركة
      A blood group 36 years old man made road traffic accident, he required urgent blood. Immediate spin cross match with 5 A blood group donors showed incompatible. Forward grouping of the patient show A Rh positive and Reverse grouping showed agglutination in both A & B cells.
      blood group is A RH +ve depend of forword
      in reverse: false +ve reaction may be due to unexpected antibodies other than anti A or anti B
      - in situation such as a group A individual reacting with both the A1 and B reagent cells.
      - clod agglutinins are another cause of unexpected +ve in revers type
      - miscellaneous problems
      - patient has circulation RBCs more than one ABO group due to RBCs transfusion or bone marrow transplant
      - caused by Polyagglutinantion due to exposure of hidden erythrocyte Ag
      - bacterial contamination

      to resolve:
      incubate at 37 c for short period then washed with saline 3 times then retype
      if not resolving patient red cells can be treated with 0.01 m dithiothreitol to dipers IgM - relate agglutination

      in emergency give patient O compatible Rh if can if not give him O
      Rh-ve

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      • #18
        المشاركة الأصلية بواسطة ayahmah مشاهدة المشاركة
        blood group is A RH +ve depend of forword
        in reverse: false +ve reaction may be due to unexpected antibodies other than anti A or anti B
        - in situation such as a group A individual reacting with both the A1 and B reagent cells.
        - clod agglutinins are another cause of unexpected +ve in revers type
        - miscellaneous problems
        - patient has circulation RBCs more than one ABO group due to RBCs transfusion or bone marrow transplant
        - caused by Polyagglutinantion due to exposure of hidden erythrocyte Ag
        - bacterial contamination

        to resolve:
        incubate at 37 c for short period then washed with saline 3 times then retype
        if not resolving patient red cells can be treated with 0.01 m dithiothreitol to dipers IgM - relate agglutination

        in emergency give patient O compatible Rh if can if not give him O
        Rh-ve

        Thank you very much for your contribution, You are quite right as far as posibilities of ABO discrepancies are concerned but if you try to concentrate on the case there are 3 keys which are:
        1. Forward grouping A Rh(D) positive: assume it is correct as patient history says he is A Rh(D) positive
        2. Incompatible cross match with all units screened
        3. Reverse grouping shows agglutination with anti-A which not supose to be the casesame

        Remember that 80% of the A group population worldwide are A1 & 20% are A2 (can produce anti-A1). Cross match with same blood group showed incomaptible because all of these units were A1 and patient serum contained anti-A1 as he is A2. Anti-A1 is cold agglutinin thats why it reacted in Immediate spin cross match. However, this is not problamatic inside body and can not cause any trabnsfusion reaction. Since patient was required urgent unit group O was correct dicision. However, providing such incompatible unit wouldnt have effected as well.

        Remeber also, In reverse grouping A1 cells are used and since patient serum contains anti-A1 it reacted with A1 cells giving agglutination which was the cause of ABO discrepancy in this case.

        Hope this helps

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        • #19
          Here you go , another case for those who are interested

          Group B child borned in an indian family with Group O father & group A mother? Explain if it is possible to have such group in the Family?

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          • #20
            المشاركة الأصلية بواسطة medical lab specialist مشاهدة المشاركة
            Here you go , another case for those who are interested

            Group B child borned in an indian family with Group O father & group A mother? Explain if it is possible to have such group in the Family?

            as an orginal blood group ,no it is not possible according to my knwoledge

            but I think this case can be seen in the baby who has a history of blood transfusion-by other than his original group- more than his blood volum....

            by the way, in this case this interpretation may not be logical ,because if
            his orginal blood group is O or A, he will not be transfused by B blood
            if he is in need!!!!! ...

            if no history of blood transfusion by B blood group given to this baby before 3 months-no antibodies prodused yet-in my opinion this baby is not belong to this family...
            http://www12.0zz0.com/2010/06/09/15/248657346.gif

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            • #21
              المشاركة الأصلية بواسطة ambitious553 مشاهدة المشاركة
              as an orginal blood group ,no it is not possible according to my knwoledge

              but I think this case can be seen in the baby who has a history of blood transfusion-by other than his original group- more than his blood volum....

              by the way, in this case this interpretation may not be logical ,because if
              his orginal blood group is O or A, he will not be transfused by B blood
              if he is in need!!!!! ...

              if no history of blood transfusion by B blood group given to this baby before 3 months-no antibodies prodused yet-in my opinion this baby is not belong to this family...

              Thanks for your contribution in this case, Giving you one more chance to make up your information and get back to the case.

              Thanks

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              • #22
                هو احتمالية فصيلة الدم للطفل وحده من الثنتين يا إنه O أو انه A ويعتمد ها الشي على صفة ال A إذا كانت homozygous معناهاكل الاطفال راح يحملون صفة الفصيلة A وإذا heterozygousهناتكون الاحتمالية بين فصيلة الدم O إلى A مناصفة 50% لكل وحدة..

                أما وجود طفل للفصيلة B في ها العايلة أعتقد مستحيلة !!!
                http://www12.0zz0.com/2010/06/09/15/248657346.gif

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                • #23
                  as in a chart this kind of blood group distribution can not be found,but now I am thinking if this baby may has any rare mutation which may change his blood group??!!!

                  really it is wrong to decide wether this baby is belong to this family or not with out
                  making sure by DNA studies..


                  I will be right back if I got any new answer.....



                  thank you mister....
                  http://www12.0zz0.com/2010/06/09/15/248657346.gif

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                  • #24
                    Back>>>>

                    I will try once again,although that I am not that much satisfied with this answer but I am trying my best to solve the case:sm180:......



                    this blood group may be an example of "dominant" and "recessive" traits??!!

                    in which one allele masks the expression of the other in influencing some trait

                    or

                    maybe controlled by more than just a single pair of alleles. In other words, it is due to a multiple-allele series....

                    I hope to be around the correct answer....
                    http://www12.0zz0.com/2010/06/09/15/248657346.gif

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                    • #25
                      Thanks for your answers, You are quite correct with your last two statements but let me sort it out now:
                      Yes it is possible to have B blood group baby in this family due to 2 reasons:

                      1. If you read carefuly a key word in this case it says indian family, therefore possibility of Bombay blood group can not be excluded, lets assume the father who is O blood group is actually Bombay blood group. Serolgical test showed O blood group as phenotype but as far as genotype is concerned he is hh genotype. ABO locus in the father could have B allele that can not show itself as phenotype due to absence of H antigen since genotype is hh. Because we inherit one allele from each parent, B gene allele can be inherited to the offspring though it is not expressed in the father

                      2. If the father is actual O blood group & not Bombay, possibility of having child with B blood still valid: Gene recombination can play a crucial role to get such rare phenomenon. Such explanation based on molecular understanding if you are interested i will explain it to you in details. Please let me know

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                      • #26
                        thank you soooooo much,

                        I do realised that this O blood group may be bomby blood group, but what I do not no actually that the absence of H antigen can mask B allel,always am keeping in my mind that when ever O blood group is there no chance of any other antigen to be there because O means =zero antigen ,so B as dominant must be expresed
                        and O as a ressesive must be masked in case of "BO", according to this general role I aplied my answers.
                        ,,,,by the way this is a new exeption I learn it from you .....
                        thank you

                        second reason you will be most thanked and appreciated if you could elaborate more
                        http://www12.0zz0.com/2010/06/09/15/248657346.gif

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                        • #27
                          المشاركة الأصلية بواسطة ambitious553 مشاهدة المشاركة
                          thank you soooooo much,

                          I do realised that this O blood group may be bomby blood group, but what I do not no actually that the absence of H antigen can mask B allel,always am keeping in my mind that when ever O blood group is there no chance of any other antigen to be there because O means =zero antigen ,so B as dominant must be expresed
                          and O as a ressesive must be masked in case of "BO", according to this general role I aplied my answers.
                          ,,,,by the way this is a new exeption I learn it from you .....
                          thank you

                          second reason you will be most thanked and appreciated if you could elaborate more
                          In simple words, Hh or HH alleles produce H transferase enzyme which adds up fucose sugar on glycolipid of the RBCs and make it to express H antigen. Modification of H antigen or conversion of H antigen to A or B antigen on red blood cell can take place if A and/or B alleles present respectively. A or B alleles produce specific transferase enzyme that can add up specific sugar on H antigen to modify it to A or B or AB blood group. This is how red blood cells ABO antigens formed. Individuals with Bombay blood group can not make H antigen since they have hh allele, therefore A, B or AB antigens will never form eventhough ABO alleles are present. Remember H antigen is always needed for ABO antigens make up.

                          As far as recombination possibility is concerned, attached is PDF file please read it and let me know if you need any clarification

                          Thanks
                          الملفات المرفقة

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                          • #28
                            that is mean that any A,B antigen was H antigen in nature......and those who are having bomby blood group can transfer the A,B blood group to the next generation although that A,B antigen is not expresed on them.....

                            attached file is really nice and simple

                            thank you mister,,,,,,
                            I think that I must return back to the IHS and learn more...
                            http://www12.0zz0.com/2010/06/09/15/248657346.gif

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                            • #29
                              An indian with Pancreatic carcinoma on treatment required urgent blood transfusion due to cancer complications. Previous hospital records showed that he is A Rh(D) positive, however Forward & reverse grouping showd different phenomenon as follows:
                              Forward grouping: Anti-A = No agglutination
                              Anti-B = No agglutination
                              Reverse grouping: A1 cells = No agglutination
                              B cells = No agglutination

                              What is correct blood group of this patient? Explain your answer? what steps should be taken to prove correct Blood group?

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                              • #30
                                What is correct blood group of this patient? Explain your answer? what steps should be taken to prove correct Blood group?


                                correct blood group of this patient=A postive

                                explaination/

                                patient is having cancer, tumor itself can cause changes in red blood cell antigens in the detection surface, seems to produce a blood change

                                also patient is under treatment so he may be exposed to the dose of radiation which may cause genetic mutations and changes in red blood cell surface antigens, resulting in blood type change,

                                all this changes will occur in bloodstrem so the blood group will be changed temporary and once the disease is controled the blood group will return to the orginal blood group beause the bone marow production has no chages ,the change is only in the blood stream as I mentioned above...

                                I have realised that there is no reaction at all in both patient cellls and plasma,I am not sure that ,is this mean that the radiation or the chemothrapy kill the cells and all the antigens and antibodies are breaked down??

                                if this correct so,is this meant that the blood group changes in all cancers' cases will be having this picture of reaction???

                                to prove blood group /

                                I think blood grouping should be done for the patient in the controled state- out of radiation effect.....

                                in this case cross match must be compatible with all blood groups,because
                                there are no antigens as well as antibodies in vitro
                                but in vivo transfusion reaction may take place becase of haemopoiesis
                                of the original blood group gathering with all original antibodies and antigen
                                التعديل الأخير تم بواسطة ambitious553; الساعة 01-02-2011, 12:12 AM.
                                http://www12.0zz0.com/2010/06/09/15/248657346.gif

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