ABO Discrepancy- lacks reactivity with B cells

[Rapundaa]

Today we have a new patient whose ABO typing is anti-A (with 3 different lots and manufacturers)=0, anti=B, anti-D=4, pt control=0, A₁ cells=0, B cells=0.  We have incubated at RT, 4 degree C and increased the plasma to cell ratio with no change in the reactivity.

 

From what little information I have a this time she does not appear to have a diagnosis that corresponds with a possible transplantation or any recent transfusion.

 

Your thoughts would be greatly appreciated.

[galvania]

Dear Rapundaa

so what you are saying is that she is grouping as a B in the cell group but an AB in the reverse group, even if you use enhanced techniques.

Can you tell us something about the patient?  How old is she, what is wrong with her?

Anna

[KatarinaN]

What was the reaction in anti-B again, 4? 

[Rapundaa]

Well proving that patient dx is almost always helpful... turns out she did have a BMT 20+ years ago. And yes the anti-B rxn was 4+ (not good proof reading on my part).

[Auntie-D]

How old is she?

[Rapundaa]

63 years old.

[Auntie-D]

It's not unusual for them to disappear with age

[Malcolm Needs ☆]

Age?  I'm 60 and my anti-B is as strong as an ox!

[Auntie-D]

Age?  I'm 60 and my anti-B is as strong as an ox!

 

Macolm I'm sorry I'm not normally ageist honest I'll soon be over the hill myself