what is the blood group for this donor?

[draaa]

HI FOR ALL

History: 21 y old man came to donate his blood in the blood bank for his mother ,

he was ok and eligible for donation,

C.B.C WITHEN NORMAL RANGES AND DAT WAS NEGATIVE AND VIROLOGY ,PRP, MALARIA AND NAT WERE NIGATIVE ALSO.

HOWEVER, IN GEL CARD AND BY TUBE TEST HIS BLOOD GROUP IN FOREWARD B+VE

BUT THE REVERSE SHOWS +2 IN A1 AND B CELLS AND BY CELL TYPING THE ANTI-H WAS POSITIVE.

THE GEL CARD WAS DONE TWICE BY MONOCLONAL AND HUMAN

THE GEL CARD WAS FROM THE DIAMED COMPANY.

PLEASE WE NEED HELP TO SOLVE HIS BLOOD GROUP

N.P: WE DID A X-MATCHING WITH GROUP O+ AND B+ AND WAS COMPATIBLE.

[Malcolm Needs ☆]

HI FOR ALL

History: 21 y old man came to donate his blood in the blood bank for his mother ,

he was ok and eligible for donation,

C.B.C WITHEN NORMAL RANGES AND DAT WAS NEGATIVE AND VIROLOGY ,PRP, MALARIA AND NAT WERE NIGATIVE ALSO.

HOWEVER, IN GEL CARD AND BY TUBE TEST HIS BLOOD GROUP IN FOREWARD B+VE

BUT THE REVERSE SHOWS +2 IN A1 AND B CELLS AND BY CELL TYPING THE ANTI-H WAS POSITIVE.

THE GEL CARD WAS DONE TWICE BY MONOCLONAL AND HUMAN

THE GEL CARD WAS FROM THE DIAMED COMPANY.

PLEASE WE NEED HELP TO SOLVE HIS BLOOD GROUP

N.P: WE DID A X-MATCHING WITH GROUP O+ AND B+ AND WAS COMPATIBLE.

I obviously don't know, but it could be something as simple as the donor having a "naturally occuring" "cold" antibody in his plasma, such as anti-M, and your B reverse cells being M+. We see this quite a lot in our Reference Laboratory.

Did you run a panel on the donor's plasma to see if there was a specific "cold" antibody present?

:confused::confused:

[draaa]

hi Malcolm

NO we did not do panel but only anti-bodies screen and was negative.

[Malcolm Needs ☆]

hi Malcolm

NO we did not do panel but only anti-bodies screen and was negative.

Presumably, however, the screen was IAT at 37oC, whereas the reverse group would have been at (approximately) room temperature?

I may be worthwhile putting up a screen/panel at room temperature, just to see.

Of course, it may be something quite different, but it's probably worth giving it a go.

:):)

[LaraT23]

Most of the time ( we do tubes) we see that the back type will have a different appearance in the abberant tube than the real back type antibody. For example, we have patients who have atypical pneumonias who will present much the same picture, but the Anti-B back type looks weaker than the real back type.

Also, what about acquired B antigen? Maybe patient is really O and the front type B is bogus? I would try tube testing to see the difference in reactions and also look in to acidified reagents for the B typing. Check to see if the gel card clone picks up the acquired B.

[Malcolm Needs ☆]

Most of the time ( we do tubes) we see that the back type will have a different appearance in the abberant tube than the real back type antibody. For example, we have patients who have atypical pneumonias who will present much the same picture, but the Anti-B back type looks weaker than the real back type.

Also, what about acquired B antigen? Maybe patient is really O and the front type B is bogus? I would try tube testing to see the difference in reactions and also look in to acidified reagents for the B typing. Check to see if the gel card clone picks up the acquired B.

I sorry Lara, but I have to disagree. As I understand it (IF, indeed, I understand it - ant it's a very big IF), only a group A individual can have acquired-B. The acquired-B antigen is caused by the action of certain bacterial exudates that de-acetylate the terminal immunodominant sugar residue of the A antigen, N-acetyl-D-galactose. A group O individual does not have this terminal immunodominant sugar residue. As I say, I'm not absolutely sure about this (but pretty sure), so don't hang me if I'm wrong!!!!!!!!!!!!

:redface::redface:

[clmergen]

My first thoughts are similiar to Malcolm's, I would check for rouleaux and then a cold antibody. We have had a B patient in the past be strongly reactive with any O cell and negative with B cells because of an auto-anti-H.

[LaraT23]

Thanks Malcolm for constantly reminding me that I really don't have the time to post on this site. Things posted on the fly are evidently not of any use. My mistake, less of me will be seen!

[Malcolm Needs ☆]

Thanks Malcolm for constantly reminding me that I really don't have the time to post on this site. Things posted on the fly are evidently not of any use. My mistake, less of me will be seen!

NO, NO, NO!

That was NOT what I meant by my post.

Please keep posting, for your sake and everybody else's sake.

I've learned a great deal from your posts.

:eek::eek:

[David Saikin]

Thanks Malcolm for constantly reminding me that I really don't have the time to post on this site. Things posted on the fly are evidently not of any use. My mistake, less of me will be seen!

Lara - you should always post. Listen to Malcolm. This site is a great sounding board for all types of ideas and experiences. Not expressing yourself diminishes its effectiveness for all of us. Keep up the good work.

[heathervaught]

IN GEL CARD AND BY TUBE TEST HIS BLOOD GROUP IN FOREWARD B+VE

BUT THE REVERSE SHOWS +2 IN A1 AND B CELLS AND BY CELL TYPING THE ANTI-H WAS POSITIVE.

...

N.P: WE DID A X-MATCHING WITH GROUP O+ AND B+ AND WAS COMPATIBLE.

I'll jump in here, although clearly not my area of expertise...I am studying to take the SBB and ABO discrepancies are definitely my biggest weakness. Please help me with my train of thought here (Malcom!).

You state the forward is Group B, but don't indicate reaction strength, leaving us to assume that his cells reacted 4+ with anti-B reagent and showed no reactivity with anti-A. This was tested with both human and monoclonal antibody preparations with agreement.

In the reverse, you have two discrepancies. The reactivity with A1 cells is unexpectedly weak, plus you have "extra" reactivity with B cells.

What I find interesting is that you performed a crossmatch with a random Group B unit and detected no reactivity. This would suggest to me that the donor's serum is reacting with an agent, such as an antigen, preservative, or an antimicrobial, that is present in the reagent cells but not on the donor cells. Effectively, the reactivity detected on the reagent B cells has been "ruled out" as anti-B.

That's where my train ends. As for the A cell reactivity, if you can't get it to react stronger, then is the donor possibly an A(sub)B with anti-A1? Can you test against A1 and A2 donor red cells?

[Malcolm Needs ☆]

Your train of thought seems perfectly logical to me Heather.

By the way, if you want to read more about ABO, there is a fantastic review by Jill Storry and Martin Olsson. It probably wouldn't help in this particular case, but it is well worth a read. It is

Storry JR, Olsson ML. The ABO blood group system revisited: a review and update. Immunohematology 2009; 25: 48-59.

:D:D:D:D

[kell23]

Thanks Malcolm for constantly reminding me that I really don't have the time to post on this site. Things posted on the fly are evidently not of any use. My mistake, less of me will be seen!

LaraT23----you have always been helpful to me so please keep posting. I value your opinion and hope you will still be talking to all of us on BBK talk.

[galvania]

Just to go back to the bit about aquired B. Diamed monoclonal anti-B reagents (tube and gel) do NOT react with aquired B.