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An ABO blood grouping discrepancy: Probable B(A) phenotype.

Ashish Jain1, Anubhav Gupta1, Sheetal Malhotra1

  • 1Postgraduate Institute of Medical Education and Research (PGIMER), Transfusion Medicine, PGIMER, Sector 12, Chandigarh - 160012, India.

Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis
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Summary

This study reports a rare B(A) blood group phenotype in a young male donor. Proper blood grouping is crucial to prevent transfusion errors and ensure recipient safety.

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Area of Science:

  • Transfusion Medicine
  • Serology
  • Immunology

Background:

  • The B(A) phenotype is an autosomal dominant trait characterized by weak A antigen expression on group B red blood cells (RBCs).
  • Accurate blood grouping is essential for safe blood transfusions, especially in blood donors.

Observation:

  • A case of a probable B(A) phenotype was identified in a 20-year-old male blood donor.
  • Initial testing revealed discrepancies between cell and serum grouping, with weak A expression noted.
  • Further investigations, including adsorption-elution techniques and gel card testing, were performed to resolve the discrepancy.

Findings:

  • The donor's red blood cells showed weak B antigen expression and variable reactions with anti-A reagents.
  • Standard serological tests, including anti-A1 lectin, confirmed the B(A) phenotype, ruling out common subgroups of A.
  • The ABO discrepancy was classified as Group II, potentially with Group IV involvement.

Implications:

  • This case highlights the importance of meticulous cell and serum grouping in identifying rare blood group phenotypes.
  • Failure to resolve such discrepancies can lead to mislabeling of blood units, posing a risk to transfusion recipients.
  • Accurate identification of B(A) phenotype is vital for preventing transfusion reactions and ensuring the availability of compatible blood products.