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Citrate-dependent auto-antibody causing error in blood grouping

S R Joshi1

  • 1Surat Raktadan Kendra, India.

Vox Sanguinis
|January 1, 1997
PubMed
Summary

An unusual autoantibody in a blood donor caused a false AB, Rh-positive blood grouping. This anti-H specificity antibody reacted with citrate, leading to misidentification until washed red cells and specific tests were used.

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Area of Science:

  • Transfusion Medicine
  • Immunology
  • Serology

Background:

  • Blood grouping errors can arise from reagent issues or unusual antibodies.
  • A volunteer blood donor initially typed as AB, Rh-positive using slide grouping presented a discrepancy.

Observation:

  • Washed red cells from the donor grouped as B, aligning with reverse serum grouping.
  • An autoantibody was identified that agglutinated red cells in the presence of citrate.

Findings:

  • The autoantibody caused false positive results with whole blood due to citrate in reagents.
  • The antibody exhibited reactivity at various temperatures and was inhibited by monosaccharides.
  • It agglutinated most red cells except for the Bombay phenotype, and its IgM nature was indicated by DTT inactivation.

Implications:

  • This case highlights the importance of using washed red cells in blood grouping when reagent anomalies are suspected.
  • The identified autoantibody demonstrates anti-H specificity, crucial for accurate blood typing and transfusion safety.
  • Understanding such rare antibodies aids in refining blood grouping protocols and preventing transfusion reactions.

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