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DAT of the case is negative. Thanks.

Dear Peter, The H antigen of the case is stronger than normal B. Cold ab had been rule out by washing cells with 37 saline. Thanks.

Cold ab had been rule out by washing cells with 37 saline. Since our lab do not have A2 cell. I haven's done this. Thanks.

Thanks a lot!!

We do not washed the cells before typing. But since the auto control have rouleaux and anti-A reaction is weak positive. Therefore, further testing, I washed the cell three times with 37 saline to eliminate rouleaux formation and other non-specific cold antibodies. Would you perform this, washed with 37C saline or just saline for further confirmation? Moreover, I used 2 random group B patient serum to react with the patient cells, the results were negative. ? reactivity against the blue dye/ base of anti-A? But how to explain the much stronger reaction with anti-H than other normal group B? Thank you !

Thank you Shily, The reaction with anti-H of 2 other B cells are weaker reaction, just weak positive and O-cell are 4+. So, I suspect it is subgroup. The reaction with anti-A is not rouleaux but very weak after washing with saline. Our lab does not perform neither the adsorption and elution test or saliva blood group. We usually send our cases to reference lab, but I want to ensure I have not miss any important step before that. Thanks a lot.

I encountered an ABO discrepancy as follow: [TABLE=width: 409] [TR] [TD=class: xl22, width: 58, bgcolor: transparent]Anti-A [/TD] [TD=class: xl22, width: 57, bgcolor: transparent]AntiAB [/TD] [TD=class: xl22, width: 51, bgcolor: transparent]Anti-B [/TD] [TD=class: xl22, width: 45, bgcolor: transparent]A cell [/TD] [TD=class: xl22, width: 50, bgcolor: transparent]B cell [/TD] [TD=class: xl22, width: 49, bgcolor: transparent]O cell [/TD] [TD=class: xl22, width: 48, bgcolor: transparent]Anti-D [/TD] [TD=class: xl22, width: 72, bgcolor: transparent]Auto ctrl [/TD] [TD=class: xl22, width: 60, bgcolor: transparent]Rh Ctrl [/TD] [TD=class: xl22, width: 53, bgcolor: transparent]anti-H [/TD] [/TR] [TR] [TD=class: xl22, bgcolor: transparent]w [/TD] [TD=class: xl22, bgcolor: transparent]4+ [/TD] [TD=class: xl22, bgcolor: transparent]4+ [/TD] [TD=class: xl22, bgcolor: transparent]3+ [/TD] [TD=class: xl22, bgcolor: transparent, align: right]0 [/TD] [TD=class: xl22, bgcolor: transparent, align: right]0 [/TD] [TD=class: xl22, bgcolor: transparent]4+ [/TD] [TD=class: xl22, bgcolor: transparent, align: right]0 [/TD] [TD=class: xl22, bgcolor: transparent, align: right]0 [/TD] [TD=class: xl22, bgcolor: transparent]3+ [/TD] [/TR] [/TABLE] After washing with warm saline, the anti-A reaction become weaker. Antibody screen is negative. The patient have rouleaux reaction with his auto control. Patient: No trasnsfusion, no leukemia or bone marrow transplant, it it similar to what have mention as B(A) type that will react with the MHO4 clone of Anti-A reagent or AxB? What further test should I do in order to confirm it? It that the anti-H have a 3+ strong reaction already suggest that it is a subgroup? Thank you for your help!