{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T14:56:55Z","timestamp":1776092215261,"version":"3.50.1"},"reference-count":10,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,4,26]],"date-time":"2017-04-26T00:00:00Z","timestamp":1493164800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Laboratory Analysis"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Bead based flow cytometry and Luminex play a major role in identification of alloantibodies in renal transplant work\u2010up. Strong sensitization events may lead to prozone phenomenon that can affect single antigen bead (<jats:styled-content style=\"fixed-case\">SAB<\/jats:styled-content>) assay and result in false negativity. However, this can also be due to high titer of other blocking antibodies. While methods like, heat inactivation, C1 inhibitor, Ethylene diamine tetra\u2010acetic\u2010acid and Dithio threitol treatment can remove interfering antibodies of complement and IgM, these methods are not optimal if false negativity is due to prozone effect, which is high titer of antibodies alone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We hereby present a case of a highly sensitized renal transplant recipient with 64% panel reactive antibody positivity (<jats:styled-content style=\"fixed-case\">PRA<\/jats:styled-content>) and a subsequent negative <jats:styled-content style=\"fixed-case\">SAB<\/jats:styled-content> assay. This paradoxical finding hinted at <jats:styled-content style=\"fixed-case\">SAB<\/jats:styled-content> being a false negative result and serial dilutions were used to perform further tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Serum dilutions lead to positive flow based panel reactive antibody (<jats:styled-content style=\"fixed-case\">PRA<\/jats:styled-content>) and flow cytometry crossmatch (<jats:styled-content style=\"fixed-case\">FCXM<\/jats:styled-content>), with an increasing trend in <jats:styled-content style=\"fixed-case\">FCXM<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In highly sensitized patients serial dilution should be considered during a transplant work\u2010up to avoid missing any underlying antibodies. Serum dilution can be used as first option to circumvent prozone. Also, interference of other antibodies should not be labeled as prozone effect.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcla.22237","type":"journal-article","created":{"date-parts":[[2017,4,26]],"date-time":"2017-04-26T12:35:10Z","timestamp":1493210110000},"source":"Crossref","is-referenced-by-count":8,"title":["False negative single antigen bead assay: Is it always an effect of prozone?"],"prefix":"10.1002","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8741-1288","authenticated-orcid":false,"given":"Dharmendra","family":"Jain","sequence":"first","affiliation":[{"name":"Molecular Genetics Laboratory Department of Pathology and Laboratory Medicine Medanta\u2010The Medicity Gurgaon Haryana India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jui","family":"Choudhuri","sequence":"additional","affiliation":[{"name":"Molecular Genetics Laboratory Department of Pathology and Laboratory Medicine Medanta\u2010The Medicity Gurgaon Haryana India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rajni","family":"Chauhan","sequence":"additional","affiliation":[{"name":"Molecular Genetics Laboratory Department of Pathology and Laboratory Medicine Medanta\u2010The Medicity Gurgaon Haryana India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pranav","family":"Dorwal","sequence":"additional","affiliation":[{"name":"Molecular Genetics Laboratory Department of Pathology and Laboratory Medicine Medanta\u2010The Medicity Gurgaon Haryana India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deepak","family":"Sharma","sequence":"additional","affiliation":[{"name":"Chimera Transplant Research Foundation Masjid Moth New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aseem K.","family":"Tiwari","sequence":"additional","affiliation":[{"name":"Molecular Genetics Laboratory Department of Pathology and Laboratory Medicine Medanta\u2010The Medicity Gurgaon Haryana India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vimarsh","family":"Raina","sequence":"additional","affiliation":[{"name":"Chimera Transplant Research Foundation Masjid Moth New Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,4,26]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1159\/000351459"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfh527"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e31822872dd"},{"key":"e_1_2_5_5_1","unstructured":"2013 InTech Rijeka J Schiettecatte E Anckaert J Smitz HL Norman TK Christopoulos Interferences in immunoassays 45 62"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/bmb\/ldu005"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.13650"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1744-313X.2012.01147.x"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2014.10.018"},{"key":"e_1_2_5_10_1","doi-asserted-by":"crossref","unstructured":"K\u0131l\u0131\u00e7aslan AynaT \u00d6zk\u0131z\u0131lc\u0131k Ko\u00e7yi\u011fitA.Detection of prozone antibodies by flow cytometer flow cytometry\u2010select topics M.Sc.;2016. Schmid I ed. InTech.https:\/\/doi.org\/10.5772\/62553. Available from:https:\/\/www.intechopen.com\/books\/flow-cytometry-select-topics\/detection-of-anti-hla-antibodies-by-flow-cytometer. Accessed October 26 2016.","DOI":"10.5772\/62553"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2008.07.045"}],"container-title":["Journal of Clinical Laboratory Analysis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjcla.22237","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcla.22237","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,26]],"date-time":"2023-09-26T20:17:32Z","timestamp":1695759452000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jcla.22237"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,4,26]]},"references-count":10,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2018,2]]}},"alternative-id":["10.1002\/jcla.22237"],"URL":"https:\/\/doi.org\/10.1002\/jcla.22237","archive":["Portico"],"relation":{},"ISSN":["0887-8013","1098-2825"],"issn-type":[{"value":"0887-8013","type":"print"},{"value":"1098-2825","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,4,26]]},"article-number":"e22237"}}