{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T06:16:50Z","timestamp":1788416210380,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"vor","delay-in-days":244,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Immunology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>For patients with multiple alloantibodies against red blood cells (RBCs), the challenges posed by transfusion practice are immense due to complex serological reactions that make finding matching units difficult. Identifying underlying antibodies is necessary to prevent hemolytic transfusion reactions (HTRs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To outline a systematized immunohematologic strategy for the detection and management of several alloantibodies in a surgical patient.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A 64\u2010year\u2010old O\u2010positive female was scheduled for spinal surgery and had a positive pre\u2010transfusion antibody screen. Automated and manual techniques, including multi\u2010cell panels, enzyme\u2010treated cells, thermal amplitude testing, extended phenotyping, DAT, and acid elution, were used in antibody investigation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The alloantibodies anti\u2010s and anti\u2010E were proven to be warm\u2010reactive IgG. The cold\u2010reactive IgM alloantibodies anti\u2010P1 and anti\u2010N were similarly shown to exhibit characteristic temperature reactivity. Anti\u2010Fyb was suspected, but not excluded, for a lack of homozygous rule\u2010in cells. Eluates showed an anti\u2010s reaction with transfused RBCs, consistent with recent exposure. Antigen\u2010negative, phenotype\u2010compatible RBCs were selected that only reacted in the antiglobulin stage, although spin incompatibilities were immediate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case highlights the significance of systematic approaches to antibody rule\u2010in\/rule\u2010out, the thermal\u2010phase test, and phenotype\u2010directed transfusion in patients with multiple alloantibodies. A clear distinction must be made between clinically significant IgG antibodies and cold\u2010reactive IgM antibodies to ensure safe, timely transfusion management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/crii\/4700436","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:52:32Z","timestamp":1788414752000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Patient With Multiple Alloantibodies: A Systematic Strategy for Antibody Identification and Transfusion Management"],"prefix":"10.1155","volume":"2026","author":[{"given":"Ahmed","family":"Alharbi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haya","family":"Wasel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4080-7930","authenticated-orcid":false,"given":"Eman","family":"Almutairi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nourah","family":"AlHarethi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulmohsen","family":"Alotaibi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jalal","family":"Hassan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiyam","family":"Almutairi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rayyan","family":"Alotaibi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maram","family":"Alonayzan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah Abdullah","family":"Alobaidi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah Al","family":"Otaibi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Majd Al","family":"Anazi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hajer","family":"Aziz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rawan","family":"Alfraidi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanad Al","family":"Harthi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saleh","family":"Almutairi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Shareefi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bandar Al","family":"Qahtani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atheer","family":"Aloqayli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,2]]},"reference":[{"key":"e_1_2_13_1_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2011-11-327361"},{"key":"e_1_2_13_2_2","first-page":"202","article-title":"Alloimmunization in Patients With Sickle Cell Disease: Risk Factors and Impact on Morbidity","volume":"36","author":"Dinardo C. 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