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CASE REPORT
Year : 2019  |  Volume : 4  |  Issue : 1  |  Page : 101-104

Resolution of blood group discrepancy and transfusion support to a nontransfusion-dependent thalassemia patient with anti-C and anti-N alloantibodies


1 Department of Transfusion Medicine and Blood Bank, All India Institute of Medical Science, Bhubaneswar, Odisha, India
2 Department of Transfusion Medicine, SCB Medical College, Cuttack, Odisha, India

Correspondence Address:
Dr. Debasish Mishra
Department of Transfusion Medicine and Blood Bank, All India Institute of Medical Science, Bhubaneswar, Odisha
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/GJTM.GJTM_30_18

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Nontransfusion-dependent thalassemia (NTDT) patients generally do not require regular blood transfusion, but may be transfused before surgery. Blood group discrepancy exists when forward grouping and reverse grouping do not match. Pretransfusion testing includes ABO/Rh typing, antibody screening, and cross-matching. Forward grouping and reverse grouping were done using monoclonal anti-A, anti-B, and anti-D (Tulip Diagnostics, Goa, India) and in-house prepared 5% A, B, and O cell by conventional tube test method, respectively. Antibody screening and identification were done using 3-cell panel and 11-cell panel (Ortho Clinical Diagnostics, USA), respectively. In our case, we found a discrepancy in reverse grouping and incompatibility due to anti-c and anti-N alloantibodies. Three units of O positive, c and N antigen negative blood units were transfused to this patient. The patient was also managed by hematinics, antibiotic, and bed rest. Antiglobulin cross-matching must be done in all types of compatibility testing of RBC units. Rh and K phenotype-matched PRBC reduced the chances of alloimmunization. Proper coordination between the physician and specialist in transfusion medicine is required in case of alloantibody formation.


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