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We report a case of Wegener's granulomatosis (WG) who very well responded to the combination strategy of therapeutic plasma exchange (TPE) and immunosuppression. The patient was a 38-year-old female, diagnosed with severe form of WG. A total of seven cycles was performed with 1.3 total plasma volumes (TPVs) on every alternate day. Standard induction therapy was also started that comprised of a combination of 500 mg intravenous (i.v.) cyclophosphamide and methylprednisolone 1 g slow i.v. daily for 3 days followed by oral prednisolone 60 mg daily for 4 weeks. After seven cycles of TPE, the patient improved and hence TPE was stopped.CD38 is a disulfide-linked molecule present on red blood cells (RBCs) and daratumumab; an anti-CD38 monoclonal antibody is a novel agent for treating multiple myeloma patients. It also binds to the RBC along with the plasma cells in concern, creating a menace in the immunohematology workups and requires the use of dithiothreitol-treated cells to rule out its interference. Appropriate and timely communication with the clinicians about the patient history goes a long way in solving complex looking immunohematology workups.Herein, we report a case of naturally occurring anti-Leb alloantibody identified in the plasma of a first time voluntary blood donor. The immunohematology workup was done on the pilot sample tubes collected during blood donation by the conventional tube technique and using ID-Micro Column System Glass Beads card (anti-IgG, C3d; Ortho-Clinical Diagnostics, Raritan, New Jersey, USA). Blood group of the donor was confirmed to be B RhD positive, and the alloantibody in his plasma was identified as anti-Leb, having clinically significant characteristics. Since in this particular case, anti-Leb was IgM and IgG in nature, it was clinically significant and can lead to hemolytic transfusion reaction, especially if such fresh frozen plasma unit is transfused to Leb negative patients.Iron overload-associated organ damage in transfusion-dependent anemias is a well-known phenomenon. Here, we discuss a case of 28-year-old, poorly chelated thalassemia major patient, whose blood workup revealed pancytopenia and moderately raised serum ferritin levels. His bone marrow examination was performed which revealed massive iron overload. Aggressive iron chelation led to successful recovery of peripheral blood counts in his patient. This case focuses on the importance of early detection and timely management of reversible iron overload toxicities. Serum ferritin although is convenient marker to asses iron overload, but it should not be relied upon to assess the severity of iron overload. Hence, organ-specific diagnostic modalities must be used along with serum ferritin to assess the severity of iron overload to prevent long-term complications in patients with regular blood transfusions.Rh blood group is one of the most complexes of the human blood groups system. RHD gene encodes the D antigen, and the RHCE encodes the C, c, E, and e antigens. Out of these, Rh D antigen is the most immunogenic while e antigen is the least immunogenic. Rh antibodies are produced in Rh-negative individuals following sensitization which occurs either through pregnancy or during blood transfusion. We hereby report two cases of anti-e antibody, both presenting as major crossmatch incompatibility.Drug-induced immune hemolytic anemia (DIIHA) is a rare condition that results primarily due to drug-induced antibodies, either drug dependent or drug independent. For its diagnosis, specialized immunohematology laboratory is often required for performing complex serological tests. The exact incidence of DIIHA is not known, but as per data published by Garratty, the incidence of DIIHA is estimated to be one in million population.[1] There are many drugs which are implicated in causing DIIHA ranging from antimicrobials, antineoplastics to anti-inflammatory drugs. Among antimicrobials, cephalosporins are commonly reported to cause hemolytic anemia.[2] In this report, we present a life-threatening hemolytic reaction to cephalosporin (ceftriaxone) in a 15-year-old child, which was diagnosed and managed in a timely manner. Our patient was suddenly deteriorated after two doses of intravenous ceftriaxone, with increase in pallor, fatigue, and frank hematuria. Repeat laboratory investigations showed signs of hemolysis, presence of schistocytes, raised lactic dehydrogenase, and indirect bilirubin. Reticulocyte count was 3.4%. Direct antiglobulin test was strong positive (4+) with IgG and C3d positive. Testing for drug-dependent antibody confirmed the presence of ceftriaxone-dependent antibody. Drug was stopped immediately. There was a rapid improvement in patient's general condition after discontinuation of drug. Laboratory parameters were improved after 48 h, and the patient was stable with no further drop in hemoglobin and hemolytic episodes. IMD0354 We suggest the need for proper immunohematological services to diagnose and solve such complex cases promptly.Hereditary persistence of fetal hemoglobin (HPFH) is a benign condition in which significant fetal hemoglobin production continues well into adulthood, disregarding the normal shutoff point after which only adult-type hemoglobin should be produced. The percentage of incorrect expression might be as low as 10%-15% or as high as 100% of the total hemoglobin, usually higher in homozygotes than in heterozygotes. The present case is a typical example of homozygous HPFH.

This study was performed to provide information on frequencies of ABO, Rh & Kell antigens/alleles, phenotype in blood donors at Blood Bank, SMS hospital, Jaipur and to compare them with other races.

This study was conducted on blood donors from April 2016 to March 2017 using a fully automated system for ABO,Rh & Kell typing of blood cells. D, C, c, E, e & K antigens were typed using monoclonal antisera from Immucor The data were collected and calculations done to determine the antigen/allele, phenotype. The chi square test 3 degree of freedom with

< 0.001 (S) was used for comparisons between the results of our study and those of other studies.

A total of 8067 donors were included in this study. Maximum donors was of B blood group (39.4%) of age 18-25(35.5%) with 60-69kg weight (65%). The most common Rh antigen found was e(99.3%) followed by D (93.8%), C (85.4%), c (60.1%), E (17.5%). R1r (DCCee) was the most common phenotype in our study (39.5%). Kell (K+) antigen was present in 2.7% of donors.

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