Case B2: Missing ABO Antibodies in an Octogenarian
Last Updated: Oct. 28, 2016 [All links fixed]
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Mr. RM is an 89-year-old male who has been admitted through the Emergency department with a broken hip. He has no history of transfusion and no other diagnosed underlying medical conditions. He takes high blood pressure medication.
- A group and screen is ordered as a precaution and in anticipation of impending surgery to repair the hip fracture.
Discussion and Resolution
After reviewing the case resolution, answer these questions:
At what age do ABO antibodies normally develop and why?
At what age do anti-A and anti-B reach adult levels and which immunoglobulin class is prevalent in adults?
Differences exist between the ABO antibody titres of adults. What are some of the causes?
Which antibody (anti-A or anti-B) usually has the stronger titre?
What causes the greater variation in the ABO antibody titres of adults: individual variation or age-related variation?
- Auf der Maur C, Hodel M, Nydegger UE, Rieben R. Age dependency of ABO histo-blood group antibodies: reexamination of an old dogma. Transfusion 1993;33(11):915-8. [ Medline ]
- British Columbia Provincial Blood Coordinating Office. Technical resource manual for hospital transfusion services, ed.2. Vancouver: Provincial Blood Coordinating Office;2006. See CT.003 ABO group problem solving.
- Issitt PD, Anstee DJ. Applied blood group serology. 4th ed. Durham, NC: Montgomery Scientific Publications;1998.
- AABB Technical Manual (latest edition)