Transfusion reaction in a with the rare Bombay blood group - Case Study Example

Transfusion Reaction in a Case with the Rare Bombay Blood Group Transfusion Reaction in a Case with the Rare Bombay Blood Group The case is about a 62-year-old female patient that initially suffered from chest pains. Diagnosis indicated unstable angina. Further angiography revealed a three-vessel arterial disease. The case represents a classical instance of misdiagnosis in determining the patient’s blood group occasioning transfusion with the wrong blood group. The patient had Bombay blood phenotype instead of the usual blood group O.

The focus, in this case, is to determine the blood group of the patients and phenotypes in an accurate manner.Bombay phenotype belongs to the ABO blood group and rarely occurs (Shahshahani, Vahidfar, & Khodaie, 2013). An occurrence of antigen H, synthesized by H gene, determines the expression of the A and B antigens. The antigen is a substrate for enzymes A and B transferases encoded by ABO blood group genes present on chromosome 19 of the human genome. Due to the absence of transferases in O group, H substance persists on the RBCs leading to the inability of Bombay phenotype patients to synthesize the two antigens.

In addition, ABH antigens do not exist in their red blood cells. When transfuse with incompatible blood groups, a hemolytic reaction occurs in Bombay phenotypic recipients.Misdiagnosis in through blood group determination is prevalent in patients with the Bombay phenotype. Bombay phenotype individuals exhibit a high presence of anti-H in their plasma (Shahshahani et al., 2013). The strong presence of antigen H explains the occurrence of hemolytic reaction when transfused with any other blood type apart from Bombay phenotype blood group.

Hemolysis is a prerequisite for disseminated intravascular coagulation (DIC) responsible for the symptoms witnessed in the patient. Decreasing cases of misdiagnosis in blood group determination entails incorporating reverse blood grouping together with O control cells to enhance identification of Bombay phenotype donors.ReferenceShahshahani, H. J., Vahidfar, M. R., & Khodaie, S. A. (2013). Transfusion reaction in a case with the rare Bombay blood group. Asian Journal of Transfusion Science, 7(1), 86–87.

 http://doi.org/10.4103/0973-6247.106754