Question

Case Study 5: Name: Sam Olds Age: 91yo Sex: M Diagnosis: Hip Replacement History of Transfusion: No History of Pregnancy: No DAT Rh REVERSE TYPING WEAKDT FORWARD TYPING Anti-A Anti-B Anti- | Anti-D IS Auto A1 B Cells AHG C C AB Control Cells 0 4+ 4+ 4+ T0 TOTO NP NP AHG C C NP NP Questions: 1. Interpretation of reactions: a. ABO Cell typing: b. ABO Serum typing: c. Rh Type: d. IS Auto Control: 2. Discrepancy noted: 3. Possible causes of discrepancy: 4. Possible procedures to resolve discrepancy: 5. What is the most probable blood type:

Answer 1

ABO grouping is used to demonstrate individual's Blood type

if the patient has blood type A, the patient’s red blood cells will clump with antibody A (Anti-A), but will not show any clumping with antibody B (Anti-B).Because the RBC contain naturally occuring antibody e.g in Group B the antibody is anti A and in group A that is anti B When antibody A (Anti-A) or antibody B (Anti-B) reagent is added to the patient’s red blood cells the antigens on the cells will cause the cells to react with the antibodies.E,g see below

Blood group A	Antigens Present on RBCs Used in forward typing	Antibody Present in Serum used in Reverse typing
A	A antigen	Anti B
B	B Antigen	Anti A

The forward typing results are used to determine the patients blood types. So here it is Blood type is B and Rh is Positive

When results are interpretaed sign (+) is considered positive, zero (0) is considered negative, and all reactions are graded on a scale of zero to most positively reactive (4+). For example, if the patient is blood type A, then the forward results will have a 3 to 4 plus positive result with the Anti-A and a negative result with the Anti-B. The reverse typing should be the opposite of the forward typing. A cells will be negative and the B cells will be 2 to 4 plus positive.

Here in reverse typing or serum typing Both A abd B is zero negative means it is showing Group AB, Here discrepancy with forward typing is present .Here Anti A should be 4+ as in serum typing the blood group is showing AB

see below

	Forward Typing AntiA	Forward Typing Anti B	Reverse typing A Cells	Reverse typing B Cells
Agp	4+	0	0	4
Bgp	0	4+	4+	0
AB	4+	4	0	0
O	0	0	4	4+

All patients are either Rh D positive or Rh D negative. using Anti-D reagent and patient red blood cells(auto control) we can determine whether he is RH positive or negative.. If the patient’s red blood cells contain the D antigen (Rh D factor), there will be agglutination when tested with Antibody D (Anti-D) and the patient is considered Rh D positive.