Exercise 4: Case Study

Case 6-1
A 45-year-old woman, who has given birth to three children and has a history of five cases of
dilation and curettage, is scheduled for a partial hysterectomy at a community hospital.
Preoperative laboratory tests include a type and screen. There is no history of transfusions.

Part 1

ABO and Rh Typing

Anti-A Anti-B Anti-A,B Anti-D A1Cells B Cells

3+ 0 3+ 3+ 2+ 4+

1. Where is the discrepancy?

There’s an ABO discrepancy in the reverse group due to the 2+ reaction with reagent A1
rbcs.

2. What testing would you perform next to resolve the discrepancy?

You would type the patient’s rbcs with anti-A1 lectin (Dolichos biflorus).

Part 2

The patient’s serum was then tested with A2 cells and O cells and the patient’s red blood cells
tested with Anti-A1 lectin.

A2 Cells O Cells Anti-A1 Lectin

Patient serum 0 0 Patient RBCs 0

3. How would you interpret these results?

The patients cell type is not A1. With the addition of serum, the antibody is not directed towards
an alloantibody reaction. In addition, the antibody is not anti A because it would react with A2
cells. Results indicate that the patient is most likely group A2 and formed an anti-A1.

4. Why were O POS RBCs chosen for transfusion?

The patient was compatible with the O positive blood and the hospital had an ample supply of O
positive blood to give to the patient.