Transfusion practice blind spot in para-Bombay: A case report

• Published in: Transfusion and apheresis science Vol. 60; no. 3; p. 103076
• Main Authors: Abdullah, Mohd Redzuan, Faizli, Afif Alam, Noordin, Siti Salmah, Lee, Chin Jian, Ahmad, Nor Hafizah
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.06.2021
• Subjects: ABO Blood-Group System - genetics; Blood Transfusion - methods; H-deficient phenotype; Humans; Male; Middle Aged; Para-Bombay; Red blood cells; Transfusion; Para-Bombay; H-deficient phenotype; Red blood cells; Transfusion
• ISSN: 1473-0502; 1878-1683
• DOI: 10.1016/j.transci.2021.103076

H-deficient phenotype individuals with absent or weak anti-H activity may remain undetected on standard routine blood grouping. We report a case of a 59-year-old-man presented with symptomatic anaemia secondary to upper gastrointestinal bleed with haemoglobin level of 68 g/L who required two units of packed red blood cells. He was previously grouped as O Rh D positive and had a history of uneventful multiple blood transfusions. His latest pre-transfusion investigations showed ABO discrepancy between forward and reverse blood grouping, pan-agglutination in both antibody screening and identification with negative direct Coombs test and autocontrol. Further testing including anti-H lectin test and saliva secretor study confirmed that the patient blood group was para-Bombay B RhD positive. This case highlights that the para-Bombay phenotype can be mistakenly labelled as “O” if further investigations are not performed.