STEP 3. Repeat with the next negative sample (number four), thus
E K Lea
(d) STEP 4. Consider only the determinants that have not been
Do all panel cells that react possess these?
1 Sample number two is rh" (E)-negative but Le (a+).
2 Sample number five is rh" (E)-positive, Le (a-).
3 Sample number six is rh"(E)-positive, Le (a+).
(e) STEP 5. Interpretation: The RBCs that react are not all rh"(E)-
positive nor are they all Le (a+). There is a difference in the serologic behavior
(numbers 2 and 6 are hemolyzed, number 5 is not). These two observations suggest a
mixture of antibodies.
1 Hemolysis of samples two and six indicate a complement-
binding antibody. Antibodies of the Rh system do not hemolyze RBCs "in vitro".
Therefore, the hemolysis is probably a result of the anti-Lea.
2 Both RBC samples five and six are rh" (E)-positive. The
optimum activity with high-protein, antiglobulin, and enzyme techniques is expected with
antibodies of the Rh system.
STEP 6. Confirmation of antibody identity:
1 The RBC phenotype of the subject is found to be Rho- (Dccee),
2 The serum is tested with RBCs from selected donors:
a The rh" (E)-negative, Le (a-) cells do not react.
b The rh" (E)-positive, Le (a-) cells react.
c The rh" (E)-negative, Le (a+) cells react.