Immunohematology最新文献

{"title":"Genotyping for Dombrock blood group alleles in Northern Pakistani blood donors.","authors":"S A Jadoon, N Salamat, S A Khan, M S Yazdani, N Khatak, M A Naeem","doi":"10.21307/immunohematology-2021-016","DOIUrl":"https://doi.org/10.21307/immunohematology-2021-016","url":null,"abstract":"Abstract Genotyping can be used to identify rare blood group antigens and to solve suspected blood group discrepancies, particularly when serologic methods are limited. Unfortunately, only a few such studies have been performed in Pakistan. The present study was conducted to determine the frequency of Dombrock blood group alleles by genotyping samples from blood donors from the north of Pakistan. Blood samples were taken with consent from 300 blood donors; DNA was extracted and tested for DO*01 and DO*02 alleles by sequence-specific primer polymerase chain reaction (PCR-SSP), followed by gel electrophoresis. Allele frequencies were calculated. The observed and expected genotype frequencies were compared using the χ 2 test. The allele frequencies for DO*01 and DO*02 were 0.40 and 0.60, respectively. Genotype frequencies were in Hardy-Weinberg equilibrium. This study in Pakistani blood donors provides Dombrock blood group allele frequencies by PCR-SSP. This approach is efficient and economical and can be applied in developing countries. The findings can contribute to the development of in-house red blood cell panels, identification of rare blood types, and establishment of a national rare blood donor program.","PeriodicalId":13357,"journal":{"name":"Immunohematology","volume":"37 3","pages":"113-117"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39496396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immune erythrocyte antibodies in adult patients with sickle cell disease and blood donors in Lagos, Nigeria: a comparative study.","authors":"A S Adewoyin,&nbsp;O A Daramola,&nbsp;A A Ogbenna,&nbsp;T A Adeyemo","doi":"10.21307/immunohematology-2021-020","DOIUrl":"https://doi.org/10.21307/immunohematology-2021-020","url":null,"abstract":"<p><p>Sickle cell disease (SCD) poses a major public health challenge in sub-Saharan Africa, including Nigeria. Blood transfusion is a mainstay in SCD treatment. Erythrocyte alloimmunization is known to complicate the transfusional care of patients with SCD. Immune alloantibodies are associated with hemolytic transfusion reactions and transfusion refractoriness. We aimed to determine the prevalence, specificities, and clinical associations/risk factors of immune erythrocyte alloantibodies among adult patients with SCD compared with healthy blood donors in Lagos, Nigeria, through a cross-sectional study. All participants were interviewed using a structured questionnaire to obtain details on bio-data, hemoglobin phenotype, blood transfusion history, and SCD history where relevant. Blood specimens obtained from each participant were subjected to antibody screening/identification using tube agglutination method. The mean age of the SCD participants and healthy blood donors was 27.92 and 29.04 years, respectively. The majority (72.5%) of the SCD participants had received at least 1 unit of red blood cell (RBC) transfusion in their lifetime, compared with only 7.5 percent of blood donors. Six SCD participants (7.5%) tested positive for atypical erythrocyte alloantibodies, with none among blood donors. Most of the antibodies (75%) belonged to the Rh blood group system. The most frequent antibody was anti-E, followed by anti-C and anti-D. Advancing age (30 years or more), recent transfusions (last 4 weeks), higher transfusion rates, and established renal disease were significantly associated with alloimmunization (<i>p</i> values of 0.026, 0.043, 0.002, and 0.043, respectively). This study suggests blood transfusion as a strong risk factor for RBC alloimmunization in SCD patients. Extended RBC phenotyping is recommended for all patients with SCD, especially those receiving regular transfusions.</p><p><p>Sickle cell disease (SCD) poses a major public health challenge in sub-Saharan Africa, including Nigeria. Blood transfusion is a mainstay in SCD treatment. Erythrocyte alloimmunization is known to complicate the transfusional care of patients with SCD. Immune alloantibodies are associated with hemolytic transfusion reactions and transfusion refractoriness. We aimed to determine the prevalence, specificities, and clinical associations/risk factors of immune erythrocyte alloantibodies among adult patients with SCD compared with healthy blood donors in Lagos, Nigeria, through a cross-sectional study. All participants were interviewed using a structured questionnaire to obtain details on bio-data, hemoglobin phenotype, blood transfusion history, and SCD history where relevant. Blood specimens obtained from each participant were subjected to antibody screening/identification using tube agglutination method. The mean age of the SCD participants and healthy blood donors was 27.92 and 29.04 years, respectively. The majority (72.5%) of the SCD participants had rec","PeriodicalId":13357,"journal":{"name":"Immunohematology","volume":"37 3","pages":"131-137"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39496397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of anti-Jk3 associated with silenced Kidd antigen expression and a novel single nucleotide variant of the <i>JK</i> gene.","authors":"P A Manrai,&nbsp;A J Siddon,&nbsp;K M Hager,&nbsp;J E Hendrickson,&nbsp;M A Keller,&nbsp;C A Tormey","doi":"10.21307/immunohematology-2021-015","DOIUrl":"https://doi.org/10.21307/immunohematology-2021-015","url":null,"abstract":"<p><p>Anti-Jk3 is a rare alloantibody to a high-prevalence antigen primarily seen in individuals of Polynesian descent and is associated with a handful of well-established variants of the <i>SLC14A1</i> gene. We report a case of the Jk_null phenotype, associated with formation of anti-Jk3, in a patient of non-Polynesian descent. This patient, a 51-year-old woman self-described as of Jamaican and Scottish ancestry, presented to our hospital for oncologic care. The patient's blood sample typed as blood group A, D+. All screening and panel reagent red blood cells showed reactivity, ranging from 2 to 4+; autocontrol and direct antiglobulin test were both negative. Antigen phenotyping revealed Jk(a-b-), leading to suspicion for anti-Jk3, which was subsequently confirmed by our immunohematology reference laboratory. Given her reported familial background, testing of the <i>SLC14A1</i> gene was performed, revealing that the patient was heterozygous for the single nucleotide variant (SNV) at c.838G>A in exon 8 and therefore carries both <i>JK*01</i> and <i>JK*02</i> alleles that encode Jk^a and Jk^b, respectively. However, the patient was found to be heterozygous for several additional SNVs: c.28G>A in exon 3; c.191G>A, c.226G>A, and c.303G>A in exon 4; and c.757T>C in exon 7. The patient's Jk(b-) phenotype can be explained by coinheritance of c.838A with c.191G>A, which defines null allele <i>JK*02N.09.</i> Coinheritance of SNVs c.28G>A and c.838G with rare SNV c.757C that is predicted to cause a non-conservative amino acid change (p.S253P) likely accounts for the complete serologic absence of Jk^a and the ability to form anti-Jk3 in this case. This finding would represent a new <i>JK*01</i> null allele. This evaluation illustrates the importance of genetic analysis in identifying the factors preventing a high-prevalence antigen from being expressed, particularly when discovered outside of an expected racial or ethnic group.</p><p><p>Anti-Jk3 is a rare alloantibody to a high-prevalence antigen primarily seen in individuals of Polynesian descent and is associated with a handful of well-established variants of the <i>SLC14A1</i> gene. We report a case of the Jk_null phenotype, associated with formation of anti-Jk3, in a patient of non-Polynesian descent. This patient, a 51-year-old woman self-described as of Jamaican and Scottish ancestry, presented to our hospital for oncologic care. The patient’s blood sample typed as blood group A, D+. All screening and panel reagent red blood cells showed reactivity, ranging from 2 to 4+; autocontrol and direct antiglobulin test were both negative. Antigen phenotyping revealed Jk(a–b–), leading to suspicion for anti-Jk3, which was subsequently confirmed by our immunohematology reference laboratory. Given her reported familial background, testing of the <i>SLC14A1</i> gene was performed, revealing that the patient was heterozygous for the single nucleotide variant (SNV)","PeriodicalId":13357,"journal":{"name":"Immunohematology","volume":"37 3","pages":"109-112"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39496398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A mild case of hemolytic disease of the fetus and newborn due to anti-Sc2.","authors":"M A Núñez Ahumada,&nbsp;C E Arancibia Aros,&nbsp;C E Villalobos Pavez,&nbsp;F M Pontigo Gonzalez,&nbsp;V Abarca Arce,&nbsp;M Sandoval Medrano,&nbsp;S Reyes Jorquera","doi":"10.21307/immunohematology-2021-018","DOIUrl":"https://doi.org/10.21307/immunohematology-2021-018","url":null,"abstract":"<p><p>We report the case of a newborn girl with jaundice due to increased indirect bilirubin with a positive direct antiglobulin test (DAT) and compensated hemolysis. The result of the newborn's DAT was discrepant with the negative result of the mother's indirect antiglobulin test. The multiparous mother had a previous history of fetal hydrops miscarriage, with no known cause, and no record of the cause was found at the hospital where she was treated. After referring samples from the mother and newborn to a reference laboratory, the rare alloanti-Sc2 was identified in the mother's plasma and in the newborn's eluate. HEA BeadChip genotyping of the newborn's DNA sample predicted the SC:1,2 phenotype.</p><p><p>We report the case of a newborn girl with jaundice due to increased indirect bilirubin with a positive direct antiglobulin test (DAT) and compensated hemolysis. The result of the newborn’s DAT was discrepant with the negative result of the mother’s indirect antiglobulin test. The multiparous mother had a previous history of fetal hydrops miscarriage, with no known cause, and no record of the cause was found at the hospital where she was treated. After referring samples from the mother and newborn to a reference laboratory, the rare alloanti-Sc2 was identified in the mother’s plasma and in the newborn’s eluate. HEA BeadChip genotyping of the newborn’s DNA sample predicted the SC:1,2 phenotype.</p>","PeriodicalId":13357,"journal":{"name":"Immunohematology","volume":"37 3","pages":"122-125"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39496395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A unique approach to screen for blood donors lacking high-prevalence antigen In^b of the Indian blood group system.","authors":"S R Joshi,&nbsp;S B Senjaliya,&nbsp;H D Maru,&nbsp;P D Kshirsagar,&nbsp;S S Kulkarni,&nbsp;P Shrivastava","doi":"10.21307/immunohematology-2021-019","DOIUrl":"https://doi.org/10.21307/immunohematology-2021-019","url":null,"abstract":"<p><p>The In^b antigen of the Indian blood group system is a high-prevalence antigen. The presence of alloanti-In^b in a recipient may pose a problem in finding compatible blood for transfusion. The aim of this study was to screen blood donors for In^b and to include individuals found to be In(b-) in our rare donor registry. To save resources, a unique study design was constructed. Blood group O donors were tested for In^b because their red blood cell (RBC) units could serve recipients across all ABO groups. EDTA blood samples were used for serologic and genomic testing. These samples were first tested serologically for In^a, and samples typed as In(a+) were then tested both serologically and molecularly for In^a and In^b to find homozygous <i>IN*01/01</i> [i.e., the predicted In(b-) phenotype]. A cost-conservative approach in using recycling of antibody was adopted to economize available resources. Of 6300 donors, 196 donor samples typed as In(a+) and were also found to be In(b+) when tested by serologic and genomic methods. Although none of the donors typed as In(b-), the statistical analysis suggests the expected prevalence for this rare phenotype to be 0.02 percent among the total number of donors tested. In conclusion, this report presents a unique cost-conservative approach using limited reagents to screen a large number of donors for the rare In(b-) phenotype.</p><p><p>The In^b antigen of the Indian blood group system is a high-prevalence antigen. The presence of alloanti-In^b in a recipient may pose a problem in finding compatible blood for transfusion. The aim of this study was to screen blood donors for In^b and to include individuals found to be In(b–) in our rare donor registry. To save resources, a unique study design was constructed. Blood group O donors were tested for In^b because their red blood cell (RBC) units could serve recipients across all ABO groups. EDTA blood samples were used for serologic and genomic testing. These samples were first tested serologically for In^a, and samples typed as In(a+) were then tested both serologically and molecularly for In^a and In^b to find homozygous <i>IN*01/01</i> [i.e., the predicted In(b–) phenotype]. A cost-conservative approach in using recycling of antibody was adopted to economize available resources. Of 6300 donors, 196 donor samples typed as In(a+) and were also found to be In(b+) when tested by serologic and genomic methods. Although none of the donors typed as In(b–), the statistical analysis suggests the expected prevalence for this rare phenotype to be 0.02 percent among the total number of donors tested. In conclusion, this report presents a unique cost-conservative approach using limited reagents to screen a large number of donors for the rare In(b–) phenotype.</p>","PeriodicalId":13357,"journal":{"name":"Immunohematology","volume":"37 3","pages":"126-130"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39496399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From the Editors - Change in Command for <i>Immunohematology</i>.","authors":"","doi":"10.21307/immunohematology-2021-022","DOIUrl":"https://doi.org/10.21307/immunohematology-2021-022","url":null,"abstract":"","PeriodicalId":13357,"journal":{"name":"Immunohematology","volume":"37 3","pages":"139"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39496404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of anemia of unknown origin.","authors":"L Castilho,&nbsp;S Nance,&nbsp;J R Hamilton","doi":"10.21307/immunohematology-2021-022a","DOIUrl":"https://doi.org/10.21307/immunohematology-2021-022a","url":null,"abstract":"","PeriodicalId":13357,"journal":{"name":"Immunohematology","volume":"37 3","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39496405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of anemia of unknown origin","authors":"L. Castilho, S. Nance, J. Hamilton","doi":"10.21307/immunohematology-2021-023","DOIUrl":"https://doi.org/10.21307/immunohematology-2021-023","url":null,"abstract":"Abstract One of the most difficult concepts to explain when training immunohematology staff involves the investigation of hemolytic anemias. In the transfusion service and in the immunohematology reference laboratory setting, rapid and efficient investigation can be extremely important for patients with critical anemia requiring transfusion. The flow charts presented here provide possible patient scenarios and a logical sequence for initial and subsequent serologic testing for investigation. A clinical assessment of anemia of unknown origin or the finding of an unresolved positive antibody screen in pre-transfusion patient testing begins the investigational flow process. The testing sequence is predicated on the fact that performing a direct antiglobulin test (DAT) on all patients has a low predictive value and should be reserved for patients with unexplained anemia. The process begins with assessing the results of DATs with anti-IgG and anti-C3. Subsequent charts A, B, and C aid in investigating these results. Flow Chart A is for the investigation of warm or cold autoantibody, Chart B is for the investigation of cold-agglutinin or drug-induced immune hemolytic anemia, and Chart C is for the investigation of autoantibody in the transfused patient. While the most common approaches to the initial and subsequent test results are in these flow charts, the charts are not inclusive of all possible diagnoses or presentations. These flow charts are meant to be a guide to assist the laboratory in developing a standard approach to efficient investigation and resolution in patients with unexplained anemia.","PeriodicalId":13357,"journal":{"name":"Immunohematology","volume":"37 1","pages":"1 - 4"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47454834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case series highlighting a common approach to identifying anti-Jk3.","authors":"D J A M Talabong,&nbsp;W E Kelley","doi":"10.21307/immunohematology-2021-013","DOIUrl":"https://doi.org/10.21307/immunohematology-2021-013","url":null,"abstract":"<p><p>The Kidd-null phenotype, Jk(a-b-), is rare, and a patient with this phenotype may develop anti-Jk3, a red blood cell (RBC) antibody reactive with a domain common to both Jk^a and Jk^b. Like other antibodies to high-prevalence antigens, the presence of this antibody poses challenges in the immunohematologic evaluation of these patients. Thoughtful laboratory testing is necessary to resolve the antibody specificity and to reveal other underlying antibodies. Moreover, the rarity of the Kidd-null phenotype makes finding blood donors difficult for those who need transfusion and have developed anti-Jk3. This review describes methods used in identifying anti-Jk3 in four pregnant patients. Blood bank records were retrospectively reviewed to illustrate the common approach in anti-Jk3 identification. In all cases, pertinent blood bank history was gathered, and extended RBC phenotyping was performed, followed by adsorption studies and testing of selected RBCs. Underlying antibodies were found in two of the cases. This review also reiterates some common challenges encountered with Kidd antibody analysis and highlights the importance of patient ethnic ancestry and obtaining accurate patient transfusion history.</p><p><p>The Kidd-null phenotype, Jk(a–b–), is rare, and a patient with this phenotype may develop anti-Jk3, a red blood cell (RBC) antibody reactive with a domain common to both Jk^a and Jk^b. Like other antibodies to high-prevalence antigens, the presence of this antibody poses challenges in the immunohematologic evaluation of these patients. Thoughtful laboratory testing is necessary to resolve the antibody specificity and to reveal other underlying antibodies. Moreover, the rarity of the Kidd-null phenotype makes finding blood donors difficult for those who need transfusion and have developed anti-Jk3. This review describes methods used in identifying anti-Jk3 in four pregnant patients. Blood bank records were retrospectively reviewed to illustrate the common approach in anti-Jk3 identification. In all cases, pertinent blood bank history was gathered, and extended RBC phenotyping was performed, followed by adsorption studies and testing of selected RBCs. Underlying antibodies were found in two of the cases. This review also reiterates some common challenges encountered with Kidd antibody analysis and highlights the importance of patient ethnic ancestry and obtaining accurate patient transfusion history.</p>","PeriodicalId":13357,"journal":{"name":"Immunohematology","volume":" ","pages":"84-88"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39106731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neonatal testing leading to the identification of B_h (para-Bombay) phenotype in the mother: case report with review of the literature.","authors":"G Mohan,&nbsp;A Vaidya,&nbsp;S Shastry","doi":"10.21307/immunohematology-2021-008","DOIUrl":"https://doi.org/10.21307/immunohematology-2021-008","url":null,"abstract":"<p><p>Para-Bombay is a rare phenotype with a homozygous nonfunctional <i>FUT1</i> gene and a normal <i>FUT2</i> gene leading to H-deficient red blood cells (RBCs) with or without ABH substances, depending on inheritance of the <i>ABO</i> gene. This case is about a 5-day-old male baby suffering from sepsis who required a 45-mL packed RBC transfusion. The baby's sample tested as A₁B, D+ and mother's sample tested as group O, D+ with group 4 discrepancy due to ABO isoagglutinins. Further workup of the mother's sample with anti-H lectin was negative, which suggested the mother to be group O_h, D+. Antibody screening was panreactive with negative autocontrol, suggestive of anti-H. The titer of immunoglobulin (Ig)M anti-H was 64, IgG titer using dithiothreitol was 8, and anti-IH was absent. A negative adsorption and elution test suggested that RBCs were devoid of A and B antigens. The father's sample tested clearly as group A₁, D+; hence, the <i>cis-</i>AB blood group was ruled out in the baby. The secretor study of the mother's saliva revealed the presence of B and H substances that neutralized polyclonal B and H antisera. Therefore, we concluded that the mother was of the para-Bombay (B_h) phenotype. This case highlights the importance of reverse grouping and resolving blood grouping discrepancies between mother and child-in this case because of an incongruous ABO blood type of the baby and the mother who was previously tested as group O, D+.</p><p><p>Para-Bombay is a rare phenotype with a homozygous nonfunctional <i>FUT1</i> gene and a normal <i>FUT2</i> gene leading to H-deficient red blood cells (RBCs) with or without ABH substances, depending on inheritance of the <i>ABO</i> gene. This case is about a 5-day-old male baby suffering from sepsis who required a 45-mL packed RBC transfusion. The baby’s sample tested as A₁B, D+ and mother’s sample tested as group O, D+ with group 4 discrepancy due to ABO isoagglutinins. Further workup of the mother’s sample with anti-H lectin was negative, which suggested the mother to be group O_h, D+. Antibody screening was panreactive with negative autocontrol, suggestive of anti-H. The titer of immunoglobulin (Ig)M anti-H was 64, IgG titer using dithiothreitol was 8, and anti-IH was absent. A negative adsorption and elution test suggested that RBCs were devoid of A and B antigens. The father’s sample tested clearly as group A₁, D+; hence, the <i>cis-</i>AB blood group was ruled out in the baby. The secretor study of the mother’s saliva revealed the presence of B and H substances that neutralized polyclonal B and H antisera. Therefore, we concluded that the mother was of the para-Bombay (B_h) phenotype. This case highlights the importance of reverse grouping and resolving blood grouping discrepancies between mother and child―in this case because of an incongruous ABO blood type of the baby and the mother who was previously tested as ","PeriodicalId":13357,"journal":{"name":"Immunohematology","volume":" ","pages":"59-63"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39106734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}