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Updated: Feb 1, 2026
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Author Spotlight: Enhancing Understanding and Treatment Strategies with the NEC-on-a-Chip Model
Published on: July 28, 2023
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Acquired-B phenomenon in a neonate presenting with necrotizing enterocolitis
Arunpreet Kaur1, Ashish Jain1, Neelam Marwaha1
1Department of Transfusion Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh-160012, India.
Summary
A premature infant with necrotizing enterocolitis developed an acquired B blood group phenomenon due to Klebsiella pneumoniae infection. This blood group discrepancy resolved after antibiotic treatment, highlighting the importance of clinical context in transfusion decisions.
Area of Science:
- Transfusion Medicine
- Neonatal Hematology
- Clinical Pathology
Background:
- Acquired B phenomenon is a rare condition that can cause ABO discrepancies.
- Necrotizing enterocolitis (NEC) in neonates is associated with an increased risk of infection and potential blood group alterations.
Observation:
- A 14-day-old preterm infant with NEC presented with an ABO discrepancy, initially appearing as blood group AB.
- The discrepancy was attributed to an acquired B phenomenon, likely triggered by Klebsiella pneumoniae bacteremia.
Findings:
- Forward grouping showed mixed-field agglutination with anti-B, while reverse grouping was negative.
- Specialized testing with acidified anti-B confirmed the absence of true B antigen.
- The blood group reverted to A RhD positive after a 3-week course of antibiotics.
Implications:
- This case underscores the critical role of integrating clinical findings with laboratory results for accurate blood group determination in neonates.
- Prompt recognition and management of acquired B phenomenon are essential for appropriate transfusion strategies in critically ill infants.
- Infectious etiologies, particularly Gram-negative bacteria, should be considered in neonates presenting with atypical blood group findings.
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