False positive Kleihauer tests and unnecessary administration of anti-D immunoglobulin.

Author(s): Iyer R, McElhinney B, Heasley N, Williams M, Morris K

Affiliation(s): Obstetrics and Gynaecology, Altnagelvin Area Hospital, Londonderry, Northern Ireland.

Publication date & source: 2003-12, Clin Lab Haematol., 25(6):405-8.

Publication type: Case Reports

This obstetric case shows two false negative Kleihauer tests and two persistently positive Kleihauer tests leading to unnecessary administration of anti-D immunoglobulin. A diagnosis of hereditary persistence foetal haemoglobin (HPFH) was only confirmed by access to flow cytometry making use of both anti-HbF and anti-D labels. The case highlights the importance of a high index of clinical suspicion for HPFH and the importance of access to flow cytometry estimation of minor RhD red cell populations postnatally in RhD-negative mothers.