An ABO discrepancy shows a weak D phenotype. Which explanation best fits this finding?

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Multiple Choice

An ABO discrepancy shows a weak D phenotype. Which explanation best fits this finding?

Two red cell populations in the same sample create mixed-field reactions. In ABO serology, this shows up as an apparent discrepancy because one population carries a different ABO phenotype than the other. This situation is common after transfusion or hematopoietic stem cell transplantation, where donor cells with a different ABO type mix with the recipient’s cells, producing a mixed-field pattern. The presence of two concurrent cell populations can also make reactions appear weaker or inconsistent, which can resemble an ABO discrepancy described alongside a weak D finding. Therefore, mixed-field ABO best explains the pattern. The other possibilities don’t fit as well: a true weak D is an Rh typing issue, not ABO; cord blood cells could cause unusual patterns in maternal/fetal testing but are a less general explanation for an ABO discrepancy; abnormal secretor status affects soluble antigens in secretions, not the RBC ABO antigens seen in standard testing.

Two red cell populations in the same sample create mixed-field reactions. In ABO serology, this shows up as an apparent discrepancy because one population carries a different ABO phenotype than the other. This situation is common after transfusion or hematopoietic stem cell transplantation, where donor cells with a different ABO type mix with the recipient’s cells, producing a mixed-field pattern. The presence of two concurrent cell populations can also make reactions appear weaker or inconsistent, which can resemble an ABO discrepancy described alongside a weak D finding. Therefore, mixed-field ABO best explains the pattern.

The other possibilities don’t fit as well: a true weak D is an Rh typing issue, not ABO; cord blood cells could cause unusual patterns in maternal/fetal testing but are a less general explanation for an ABO discrepancy; abnormal secretor status affects soluble antigens in secretions, not the RBC ABO antigens seen in standard testing.

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