Case B2: Missing ABO Antibodies in an Octogenarian

We Welcome Feedback: Contact This email address is being protected from spambots. You need JavaScript enabled to view it.

Last Updated: Oct. 28, 2016 [All links fixed]

If you find errors or have suggestions, fire away!

Case Report


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.


  • A group and screen is ordered as a precaution and in anticipation of impending surgery to repair the hip fracture.
  • Results

Discussion and Resolution


After reviewing the case resolution, answer these questions:

  1. At what age do ABO antibodies normally develop and why?


  2. At what age do anti-A and anti-B reach adult levels and which immunoglobulin class is prevalent in adults?


  3. Differences exist between the ABO antibody titres of adults. What are some of the causes?


  4. Which antibody (anti-A or anti-B) usually has the stronger titre?


  5. What causes the greater variation in the ABO antibody titres of adults: individual variation or age-related variation?


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.
  • AABB Technical Manual (latest edition)