Case 130 – Update 1

Thanks for all the input thus far. We are dealing with a panreactive antibody screen (see below) in a patient not previously known to our hospital trust. The sample has been sent to NHSBT red cell immunohaematology (RCI). We are confident in the patient’s ABO and Rh D group (AB D-ve)

Abpanel

We call the patient’s GP (who sent the G&S request) for more information:

  • Mr X is 54 years old
  • He has recently moved back to the UK after spending 10 years working in the USA, and registered at the practice this week
  • He has a PMH of hypertension, ischaemic heart disease (MI in 2010), type 2 diabetes and multiple myeloma. All of these conditions were managed in the USA and the GP doesn’t have further information at present
  • He attended due to SOB and some anginal chest pains. The GP noticed his anaemia (Hb 78) and has requested he attends the nearest A&E for urgent RBC transfusion in view of his angina
  • He is now at your hospital’s A&E and the team state he is slightly tachycardic (HR 119) but BP is OK (114/78). There is no active bleeding. His ECG demonstrates some T-wave inversion, troponins are awaited. The A&E consultant is treating as an acute coronary syndrome (ACS) and is keen to transfuse ASAP
  • The A&E team relay that the patient states he has had several transfusions over the last few years with no issues as far as he is aware
  • It is now 10pm on a Tuesday evening…..

What further information do you require from the patient?

What tests would the NHSBT RCI lab perform?

Are you willing to authorise RBC transfusion for this patient? If so what specifications would you request?

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