This is case report of a female with “A” sub type with acquired B antigen and non-secretor status, firstever reported with this combination in Nepal, during blood grouping of a sample of a patient withurinary tract infection. The patient was referred to our center for blood grouping, cross matching andtransfusion due to severe anemia.
During routine blood grouping, the red cells showed mixed field agglutination with anti-A, antiAB and microscopic agglutination with anti-B. On serum grouping, we detected potent Anti-B andno agglutination with anti-A. There was no reaction with anti-A both at room temperature and at37°C. Her cells were further tested with A1 Lectin and Anti-H antisera. There was strong reaction withA1 Lectin and 3+ macroscopic reaction with anti-H in addition to a positive auto-control. Her directantiglobulin test was only +1 positive. For her “B” antigen, we acidified B antisera with HCl, which didnot give any macro or microscopic agglutination with patient’s red cells. Her “Rh” status was positiveand on examining the saliva, she was found to be non-secretor.
The first choice of blood group for transfusion in this case is the “A1” sub type followed by “O” bloodgroup. As the patient had already received “A” blood group and in the presence of auto antibodies, “Asubgroup” blood transfusion should be avoided in her.