dear all,

heres a problem we at our blood bank did a blood group and found results

anti A (NEG) ANTI B(NEG) ANTI D(POS) in reverse A CELLS (NEG) B CELLS (POS) O CELLS (NEG) .

however we saw some very minute agglitinants in anti A which however disapperared after some seconds

patients age was 65 and on asking he received no transfusion in the past

please give the likelihoods

thanx

might be a weak subgroup of A or the patient has a low titer/negative anti-A.

There are two things that spring to mind.

Firstly, that he has a very weak A subgroup. You can check this either by performing adsorption and elution studies with anti-A and his red cells, or by testing his saliva for group A substance (if he happens to be a Secretor - do his Lewis typing - if he is Le(a-b+), he is a Secretor, if he is Le(a+b-), he is a non-Secretor, if he is Le(a-b-), he is an awkward customer, because he could be a Secretor or a non-Secretor).

The other thing is, did you ask him if he had ever had a Bone Marrow or Stem Cell Transplant (unlikely, if he has never had a transfusion). Very often though, group A recipients of group O marrow or stem cells do not make a strong anti-A, if at all, because either they tolerate the A antigen, or they secrete A substance that inhibits the donor cell's anti-A (or both).

Some patients, as they get older, simply have a reduction in their levels of natural Anti-A and Anti-B. While 65 is no where near as old as it used to be this could be the case.

I couldn't agree more with you John.

How strong was the reaction with the B cells? Did you let the reverse typing cells incubate at RT for 5 to 10 minutes? Sometimes that will allow a weak backtype to show up.

might be a weak subgroup of A or the patient has a low titer/negative anti-A.

probably right Mr. David.