Some Possible Explanations:
Always review the transfusion history of all component types, medication history, and the clinical history!! Start with this first.
- Receipt of plasma with anti-D (RhIG, IVIG, etc.)–passive antibodies
- Partial D with anti-D:
- Partial or mosaic D patient who received D positive RBCs and made anti-D directed against its missing epitopes
- Not all anti-G is anti-C and anti-D: It is really a separate specificity. It is possible that anti-G may be made even though the patient is C-positive.
- However, it is unlikely to show such strong reactions
Can you think of other explanations?