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Help with ABO Group


aafrin
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We had a 46 year old male health check patient who has never been transfused before come for blood grouping. He knows his blood group previously as O Rh Positive. Our results were as follows:

 

 

Tube Test

BioRad Gel

-A

1-2+ mf

0

-B

0

0

-AB

2+mf

ND

-D (igG+IgM)

4+

ND

-D (IgM)

4+

4+

A1 Lectin

0

ND

H Lectin

4+

ND

A1 Cells

1-2+ at RT, >2+ at 37 C

w-1+ at RT & 37C

B Cells

4+

4+

O Cells

0

ND

Autocontrol

0

ND

A2 Cells

0

ND

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

We repeated the blood group with two other manufacturer’s anti-sera. One anti-sera gave the same result as our tube test result, but with the other anti-sera the result with anti-A was negative.

What should we report the blood group as? O or subgroup of A? Kindly help.

Edited by aafrin
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I also agree with the subgroup of A. However, I would do other tests before considering the case as resolved.
1. Are the reagents you used from different manufacturers from the same clone? Do they have the same title? Differences in clone or titer may lead to differences in reactivity.
2. Tn antigens may be cross-reactive with some anti-A antibodies. Treatment of RBCs with the enzyme may help to exclude this interferant.
3. I would or would refer you to the molecular investigation to identify the deletion mutation at position 261 of exon 6, which characterizes O alleles.
4. Flow cytometry can also assist in the evaluation of the mixed field. Is it happening because of poor reactivity or chimerism?

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Reminds me of a donor we had once when I was a reference lab sup.  He had donated 12 times as O NEG.  The next time he donated, they picked up weak typing with Anti-A,B and with further testing, turns out he was a very weak subgroup of A!  Unbelievable.

I agree with A subgroup.  I see a lot of people want to automatically classify the subgroup....but without further testing, that is actually erroneous.  Best to just leave it at subgroup.

Brenda Hutson, MT(ASCP)SBB

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On 3/30/2018 at 6:54 PM, mpmiola said:

1. Are the reagents you used from different manufacturers from the same clone? Do they have the same title? Differences in clone or titer may lead to differences in reactivity.

They are from different clones and titer.

We repeated the blood group using BioRad Newborn Card and it showed 2+ with anti-A,B but negative with anti-A.

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