Dear colleagues,
This week a sample negative in the erythrocyte antibody screening
(3-cells panel in PEG) failed to create a positive reaction with
Coombs control cells. These are sensitized cells to check the
quality of the Coombs reagent; they are added at the end of the
test. Samples from other patients in the same run showed a
normal (positive) reaction with the control cells. Repeating the test
with freshly drawn material produced the same result.
However, on repeating the antibody screening with addition of
albumin, the control cells reacted normally (i.e. positive).
We then analysed the sample for total protein and albumin and
found 91 g/L and 31 g/L respectively.
The patient had been admitted with a sodium concentration of 199
mmol/L, osmol 259 mosmol/kg, chloride 88 mmol/L, potassium 4.8
mmol/L and a general feeling of ill well-being (!).
Now we have a request for protein electrophoresis (liver enzymes
are normal). No further clinical details available.
Regards
Raymond Wulkan
MCRZ-Zuider
Rotterdam-NL
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