This is an updated version of a previous post.
Whenever I had a “nonspecific” antibody, I had to first rule out issues with the reagents themselves. The following example shows weak to 2+ reactions in the panel cells and autocontrol.
The variability in the reactions made me initially uncomfortable about called this WAIHA. I then checked the panel details: the testing was done only six days before the panel outdate.
I told my staff to repeat the workup with the new panel expiring five weeks later. The difference is astounding!!
Remember: if you work in the Middle East, the environmental conditions can be extreme in summer (>50C). Do you know how your reagents were handling during transport?
My advice: if you are concerned there is a clinically significant antibody but cannot confirm it, consider repeating the workup using fresh reagents and a fresh specimen. Repeating the workup after a few days may make the detection clearer.
Original Panel with Near Expiry Reagents:
Test performed 7/2/06, reagents expire 13/2/06:
Same Patient with New Reagents and New Sample:
Test Performed 14/2/06, reagents expire 20/306: