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Complement-binding anti-Jka not detectable by DiaMed gels
P O'Brien1, L Hopkins, D McCarthy
1Department of Haematology and Blood Transfusion, St. Vincent's Hospital, Dublin, Ireland.
Background:
An anti-Jka was not detectable by the DiaMed-ID Micro Typing System but was strongly reactive when tested using other indirect antiglobulin test (IAT) methods. However, it was detectable in the DiaMed-ID system when the recommended diluent ID-Diluent 2, was replaced by other low ionic Strength saline (LISS) solutions. This led us to believe that the problem lay with the ID-Diluent 2.
Methods:
The anti-Jka was investigated using various low ionic strength diluents in the IAT against both polyspecific and monospecific antiglobulin reagents. We tested the ID-Diluent 2 for its ability to inhibit complement activation, and bind calcium.
Results:
The anti-Jka was shown to be a 'complement-only' binding antibody that reacted in all IATs performed except when tested with ID-Diluent 2. The ID-Diluent was shown to prevent haemolysis of ABO lytic antibodies, and further testing shows that it binds calcium.
Conclusion:
The use of a diluent which prevents haemolysis and binds calcium in an IAT system that contains anti-complement as well as anti-IgG must be questioned.