Evaluation of different testing methods for identification of RhIG in red blood cell antibody detection.

BACKGROUND: RhIG has had great success in protecting fetuses from potential harm; however, little work has been done to demonstrate how long RhIG reactivity is detected in the mother after administration when using common red blood cell antibody detection methods. STUDY DESIGN AND METHODS: A retrospective investigation was performed examining positive antibody identification panels due to RhIG. These panels were run on solid-phase (SP) testing. The time to a positive result, length of detection, and positive strength of reactivity (PSR) were evaluated. Additionally, a comparative study was performed evaluating how sensitive SP, gel (GT), and tube testing (TT) were at detecting RhIG using serially diluted plasma samples spiked with different RhIG formulas. RESULTS: Retrospectively, most antibody identification panels by SP were positive 3.5 months after RhIG administration and demonstrated a strong PSR. The longest recorded positive panel was present at 4.5 months. RhIG administered intramuscularly could not be detected until several hours after injection. The comparative study showed that SP was the most sensitive method while GT and TT were comparable to one another in detecting RhIG. SP also recorded strong PSR at very low concentrations of RhIG. GT and TT recorded weak PSR even with higher concentrations of RhIG. CONCLUSION: SP is the most sensitive testing method and has the ability to detect RhIG 4 to 5 months after administration. TT and GT have the ability to detect RhIG up to 3 to 4 months after administration. Different RhIG formulas may show slightly different lengths of detection.

A rare soft tissue tumor masquerading as a parathyroid adenoma in a patient with birt-hogg-dubé syndrome and multiple cervical endocrinopathies.

Birt-Hogg-Dubé (BHD) syndrome is an autosomal dominant disorder that presents with renal tumors, pulmonary cysts with spontaneous pneumothoraces, and skin hamartomas. We present a case of a 67-year-old female with multiple endocrinopathies and a history of BHD syndrome. In 2011, a thyroidectomy with a four-gland parathyroidectomy was performed for toxic multinodular goiter (TMNG) and parathyroid hyperplasia. On frozen section, a tumor was identified next to a hypercellular parathyroid. After being worked up, this tumor was determined to be an adult rhabdomyoma. This represents the first time that both TMNG and parathyroid hyperplasia have been present in a BHD patient. Additionally, this is the first adult rhabdomyoma reported in a patient with BHD syndrome. Adult rhabdomyomas have no reported associations; however, potential colocation of the mutation in BHD syndrome and translocation in adult rhabdomyomas on chromosome 17p suggests a possible connection. Further work is needed to better understand this connection.