One case many learnings: A case of blood group discrepancy along with multiple alloantibodies

Routinely, Immunohematology Reference Testing Center receives samples with blood group discrepancy, presence of allo/autoantibodies, positive direct antiglobulin test (DAT), etc. We are presenting a case in which we not only resolved blood group discrepancy but also identified multiple alloantibodies reacting at different phases. A tricenarian female patient was diagnosed with chronic anemia with hemoglobin level below 7 g/dl. The patient had a history of blood transfusion and pregnancy as well. On blood grouping, the patient's forward grouping was “AB” and reverse was “O.” Indirect antiglobulin test was found to be positive while DAT and autocontrol were negative. After complete investigation, patient blood group was confirmed to be subgroup of AB along with anti-A1 antibody. Furthermore, a cold-reacting alloantibody with high thermal amplitude was detected along with one warm-reacting alloantibody.