B Subgroup: Bx blood Group in a Patient : A Case Report

Abstract

This is a report of a case of B Sub Group: B_x, first ever detected in Bangladesh, while doing compatibility test of a sample of a patient undergoing cardiac surgery. The patient was referred to the transfusion medicine department of Bangabandhu Sheikh Mujib Medical University to do cross-match with 8 proposed donors of same ABO group prior to cardiac surgery. His red cells showed weak agglutination with anti-B, anti-AB and in his serum there was potent Anti-A and weak anti-B which was not detected at 37⁰C. After adsorption with anti-B an elute was prepared from patients cells which agglutinate with B and AB cells but did not agglutinate with A or O cells. The patient could be transfused with B blood but in this situation of cardiac surgery, as he should have to be kept in hypothermic condition, we transfused him with O washed red cell with AB plasma during operation. Patient was released from hospital without any complication. The weak B subgroups are: B₃, B_x & B_el. B₃ shows a mixed field of agglutination with anti B. B_x shows a weak agglutination and weak anti-B is found in the serum. B_el is not agglutinated with anti-B but is only adsorbed anti-B. With meticulous attention, cell & serum grouping of recipient and proposed donor/s to be done along with 3 phase cross-matching (Saline phase at room temp, at 4 and 37 degree Celsius temp, Indirect Coombs Test phase) to ensure right blood to the right patient at right time.

DOI: http://dx.doi.org/10.3329/bsmmuj.v5i1.11032

BSMMU J 2012; 5(1):81-82