Question

Write a brief case study on an ABO discrepency.

Answer 1

Ans-

ABO discrepancy a generic term varity of situation in which the interpretation of the patient or donor grouping result is unclear.

Where the ABO discrepancy happened with the technical error and the problem with red blood cells antigen.

Case study-

Discrepant Blood Typing Results in a 24-Year-Old Woman With a History of an Bone Marrow Transplant.the Patient is married and having 8 year old child and smoke 0.5packs in per day.

History of Present Illness-Patient presented with new papules on vagi-novulvar and perianal areas which were increased in size significantly compared to pre-vious lesions. The patient was unnable to tolerate a the colposcopic test in office,and thus the procedure was performed in the operating room under general anesthetic.Preoperativethe blood type and screen performedin the blood bank was abnormal.Biopsies of the lesion demonstrated condyloma acuminatum.cervical a biop-sy demonstrated high-grade squamous intraep-ithelial lesion.

Past Medical History-The patient was diagnosed with acute myel-ogenous leukemia (M5 subtype) in 2005.She underwent induction and consolidation chemotherapy and remained in complete Remission Approximately 9 months later, shereceived an allograft bone marrow transplant.Her allograft bone marrow transplant converted her blood type from O-negative to A-positive,and this was the only information provided that at the time of the blood bank type and screen.She now receives dialysis a for the chronic renal fail-ure. Additional past medical history includes the Wolff-Parkinson-White Syndrome with multiple arrhythmias and syncopal episodes.

Explaination of case study-

There is discrepancy between her forward and reverse typing.she forward types as the blood group A, but reverse types as blood group O.

There are some possibilities for the discrepancy that is

1)The first possibility of particular clinical concern is that these findings represent repopulation of her bone marrow bythe her native bone marrow cells. In this situation, her original O-negative the red blood cells along with circulating anti-A, anti-B, and anti-A,B antibodies would reoccur. This would be con-cerning in that she could eventually and reject her bone marrow transplant or she may be relapse into acute leukemia.

2)A second possibility -is that the patient may have been passively immu-nized via plasma-containing products. The half-life of antibod-ies (such as anti-D) administered to patients is 21 days, and thus a patient who recently received type O or type B plasma or other plasma-containing products such as platelets, would have anti-Aantibodies which may be detected in the reverse ABO-typing phase of testing. In such a situation the test is often positive (as is the auto-control). These assays were performed on her sample, and both are were negative, and thus it was concluded from the laboratory results that she did not re-ceive the blood products resulting in passive immunization.

3)A third possibility -for this finding is the presence of an immediate-spin reactive (eg, IgM) all antibody against the A1 typing cells. To the determine if this is the cause, an antibody screen was performed were and was found to be negative.

The discrepancy is significan t for her medical history because her serum contains anti-A1 anti-bodies, one might believe that the possible future red cell transfu-sions for this patient need to be performed using only A2 redcells. And In practice, however, anti-A1 is seldom, if ever, a cause of the hemolytic transfusion reactions and therefore of minimal clinical significance. However the anti-A1 antibodies are usually IgM and cold reactive,they may interfere with immediate spin crossmatches with otherwise compatible A1 red cells.patient requires immediate transfusion, O red cells of the patient’s Rh type the must be the administered. Additional pretransfusion samples may be necessary to resolve the discrepancy and should be obtained.