Which ABO/Rh group corresponds to the following serology: Anti-A 4+, Anti-B 4+, Anti-D 4+, RhC 0, A1 Cells 2+, B cells 4+, Dolichos biflorus 0?

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Multiple Choice

Which ABO/Rh group corresponds to the following serology: Anti-A 4+, Anti-B 4+, Anti-D 4+, RhC 0, A1 Cells 2+, B cells 4+, Dolichos biflorus 0?

The question tests recognizing an ABO subtyping pattern (A1 vs A2) and the presence of anti-A1 antibodies using forward and reverse typing, plus a special A1/A2 differentiation test. Forward typing shows the patient’s red cells react with anti-A and anti-B all at strong strength, which initially points to an AB phenotype. To tell if the A antigen is the A1 or A2 form, we use Dolichos biflorus lectin: a positive reaction with Dolichos would indicate A1, while no reaction (negative) means the A antigen is of the A2 subtype. Here Dolichos biflorus is negative, so the red cells are A2 rather than A1. In reverse typing, the patient’s serum is tested against A1 cells and B cells. A1 cells show reactivity (A1 cells 2+), indicating the presence of anti-A1 antibodies in the serum. Since the A antigen present on the patient’s cells is A2 (not A1), this anti-A1 antibody is consistent with an A2 phenotype (A2 individuals can have anti-A1 antibodies that react with A1 cells but not with A2 cells). Putting it together with the AB forward result and the Rh typing (D antigen positive, Rh positive), the serology describes an A2B phenotype that is Rh positive, with anti-A1 antibodies in the serum.

The question tests recognizing an ABO subtyping pattern (A1 vs A2) and the presence of anti-A1 antibodies using forward and reverse typing, plus a special A1/A2 differentiation test.

Forward typing shows the patient’s red cells react with anti-A and anti-B all at strong strength, which initially points to an AB phenotype. To tell if the A antigen is the A1 or A2 form, we use Dolichos biflorus lectin: a positive reaction with Dolichos would indicate A1, while no reaction (negative) means the A antigen is of the A2 subtype. Here Dolichos biflorus is negative, so the red cells are A2 rather than A1.

In reverse typing, the patient’s serum is tested against A1 cells and B cells. A1 cells show reactivity (A1 cells 2+), indicating the presence of anti-A1 antibodies in the serum. Since the A antigen present on the patient’s cells is A2 (not A1), this anti-A1 antibody is consistent with an A2 phenotype (A2 individuals can have anti-A1 antibodies that react with A1 cells but not with A2 cells).

Putting it together with the AB forward result and the Rh typing (D antigen positive, Rh positive), the serology describes an A2B phenotype that is Rh positive, with anti-A1 antibodies in the serum.

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