Chloramphenicol antibody causing interference in antibody detection and identification tests

Area of Science:

• Transfusion Medicine
• Immunology
• Clinical Pathology

Background:

• False positive antibody detection tests can complicate blood transfusion compatibility.
• Commercial red blood cell reagents contain additives that may elicit immune responses.

Purpose of the Study:

• To identify the cause of unexpected agglutination in antibody detection tests.
• To investigate patient antibodies reacting with commercial red blood cell reagents.

Main Methods:

• Serum analysis of patients with positive antibody detection tests.
• Testing red blood cells with and without washing.
• Characterization of identified antibodies (IgM, titer, complement binding).

Main Results:

• Antibodies against chloramphenicol, an agent in red blood cell reagents, were identified in three patients.
• Washing red blood cells eliminated agglutination.
• The identified anti-chloramphenicol antibodies were IgM, low titer, and two bound complement.

Conclusions:

• Antibodies to chloramphenicol are a cause of false positive reactions in blood banking.
• Washing commercial red blood cells removes the antigen, preventing agglutination.
• Consider preservative solution ingredients when encountering issues with unwashed reagents.