Case B2: Missing ABO
Antibodies in an Octogenarian
Case Report
History
Mr. RM is an 89-year-old male who has been admitted through the Emergency department with a broken hip. He has no history of transfusion and no other diagnosed underlying medical conditions. He takes high blood pressure medication.
Tests
- A group and screen is ordered as a precaution and in anticipation of impending surgery to repair the hip fracture.
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Discussion and
Resolution
 Case discussion, including
interactive questions with feedback.
Resolution
QUIZ
After reviewing the case resolution, answer these
questions:
- 1. At what age do ABO antibodies normally develop and why?
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- 2. At what age do anti-A and anti-B reach adult levels and which immunoglobulin class is prevalent in adults?
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- 3. Differences exist between the ABO antibody titres of adults. What are some of the causes?
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- 4. Which antibody (anti-A or anti-B) usually has the stronger
titre?
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- 5. What causes the greater variation in the ABO antibody titres of adults: individual variation or age-related variation?
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Further Reading
- Auf der Maur C, Hodel M, Nydegger UE, Rieben R. Age dependency of ABO
histo-blood group antibodies:
reexamination of an old dogma. Transfusion 1993;33(11):915-8. [ Medline
]
- British Columbia
Provincial Blood Coordinating Office. Technical
resource manual for hospital transfusion services, ed.2. Vancouver: Provincial
Blood Coordinating Office;2006. See CT.003 ABO
group problem solving.
- Issitt PD, Anstee DJ. Applied blood group serology. 4th ed. Durham, NC: Montgomery Scientific Publications;1998.
- Vengelen-Tyler V, editor. Technical manual. 13th ed. Bethesda, MD: American Association of Blood Banks;1999.
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