Patient has a forward group O Pos. Reverse group neg in A cells pos in B cells. Could this be a case of anti A2 (we use A1 cells at moment). Should testing with A2 cells solve the problem?

B

Edited February 24, 201114 yr by bethell
change

I don't think testing A2 cells will solve this problem. I think the most likely explanation is a weak isoagglutinin due to patient age or diagnosis. How much testing do you want to do? You can increase serum/cell ratio, increase incubation time or test reverse at cooler temperatures or you can just give group O red cells.

JB

Sorry reverse group should say neg in A cells, pos in B cells.

I agree with JOANBALONE, it is because weak anti-A. And there is another condition: it is the weak A antigen, you can add more serum against A antigen and use anti-AB to detect it, if use this method you can't detect it, you can do adsordtion and elution test use anti-A.

And there is another rare case is parabombay.

Edited February 25, 201114 yr by shily

Course, if yopu don't want to do all this work yourself, you could always send it to an NHSBT RCI Laboratory!!!!!!!!!!

Could the patient have been an A Positive historically, but had a group O marrow transplant?

Could the patient have been an A Positive historically, but had a group O marrow transplant?

fit, you are absolutely right. Sorry, I forget this kind of condition.

Always when ever there is an ABO discrepancy, patient history, (age, diagnosis, medication, historical blood group, ABS, blood transfusion etc) should be considered and Lab work should also be performed as described in this case by JOANBALONE. Attempt should be done to solve before the transfusion (shifting to O Cells) unless patient requires it on stat/urgent basis.