We have a case at the moment, a patient with no history, blood group by Ortho Cassette method is Anti-A 2+, Anti-B 4+, Anti-D 4+, CTRL Neg, A1 Cells 3+, B Cells Neg.
Tube group gives B Pos and the Anti-A is totally clear Microscopically not even any apparent rouleaux, however when repeated at 4°C some small agglutinates were visible. Washing the cells yielded no change in the Anti-A reaction and auto control is negative in poly cassette as is the Antibody Screen. Back group tested with A2 cells also Positive.
Is there any further tests that should be considered to try to ascertain the correct blood group? If not how would you report the blood group?
Is this likely an A Subgroup B? If so would genetics be the only way to confirm this?
Thanks