Clinical information
Diagnostic Utility:
- This test allows for the identification of the specificity of the antibody or antibodies present in the plasma/serum. It is performed when the irregular antibody screening test has yielded a positive result.
- Irregular antibodies can cause hemolytic disease of the newborn, hemolytic transfusion reactions, or rejection reactions after a transplant. That is why they are investigated in all pregnant women and before carrying out a transfusion or a transplant.
- Moreover, studies on hemolytic disease of the newborn, maternal-fetal incompatibility, and studies on possible hemolytic transfusion reactions or rejection systematically include the determination of irregular antibody screening and its corresponding identification when the screening test has yielded a positive result.
Method:
Indirect antiglobulin technique.
The plasma/serum in question is tested against a panel usually consisting of 11 red blood cells expressing different antigens to detect clinically significant irregular antibodies.
Results:
The results indicate the specificity of the detected antibody or antibodies, for example: anti-D.
You can consult our specialists about the clinical relevance of the detected antibodies.
Precautions:
Recent administration of anti-D immunoglobulin can lead to the detection of anti-D antibodies.
Diagnostic Algorithm:
Following the diagnostic algorithm (see diagram), one or more of the following tests can be conducted:
Code | Test Name | Can it be requested separately? | Is it always performed? |
---|---|---|---|
Various (*) | Erythrocyte phenotype | Yes | No |
0012 | Direct antiglobulin test | Yes | No |
Various (*) | Extended erythrocyte phenotype | Yes | No |
0016 | Differential adsorptions | No | No |
0019 | Thermal amplitude study | Yes | No |
0021 | Antibody class: IgG or IgM | Yes | No |
4918 | Irregular antibodies titre | Yes | No |
0014 | Antibody elution | Yes | No |
0022 | Antibody neutralization with plasma | No | No |
4961 | Study of antibodies against high and low-frequency antigens | Yes | No |
*Check detailed list
Turnaround Time:
- 1 day when the identification is simple, as with antibodies directed against common antigens.
- Several days may be required when the identification is complex (mixtures of antibodies or uncommon specificities).
Specimen information
Sample: Whole blood
Tube: EDTA K3 10 ml tube
Minimum volume: 6 ml
Stability:
- At room temperature: 4 days
- In refrigeration: 4 days
Transport instructions: Preferably at room temperature
Reason for rejection: Highly hemolyzed sample
Administrative information
BST Code: 0011
Test Description: Irregular antibody identification
Synonyms: Anti-erythrocyte antibody identification
Section: Immunohematology
BST Rate: Check the updated rates here.
Profiles:
- Test 0011 Irregular antibody identification can be requested alone.
- However, the laboratory performs a previous Irregular antibody screen to demonstrate the presence of irregular antibodies in the sample.
- The identification test is automatically generated when the Irregular antibody screen (test 0010) is positive.
- Identifying an antibody implies demonstrating that the patient, pregnant woman, or donor does not express the corresponding antigen. Therefore, the laboratory performs phenotyping to investigate its absence.
References
AABB Technical Manual. 19th edition. Editat per MK Fung, AF Eder, SL Spitalnik, CM Westhoff: AABB 2017