1. Prepared by: Karaleigh Leonard, MLS(ASCP)CM
Reviewed by: Lorraine Blagg, MA, MLS(ASCP)CMSBB

Clinical vignette:
An elderly patient with end stage renal disease and multiple myeloma presents for management of an unrelated illness. On admission, hemoglobin is 6.7g/dL and type and screen is sent to the Blood Bank.

What is the most likely cause of the extra reactivity in the patient's reverse type?