Panagglutination of red blood cells complicating blood typing: A Malagasy case report

Bronislaw Tchestérico DODOSON 1, *, Jocia FENOMANANA 1, Todisoa Mahenina RAHERITIANA 2, Stéphania NIRY MANANTSOA 3, Manevarivo Eddy RAMAMINIAINA 4, Zely Arivelo RANDRIAMANANTANY 4, Andriamiadana Luc RAKOTOVAO 5 and Aimée Olivat RAKOTO ALSON 3

1 Medical biology laboratory, UHC Andrainjato Fianarantsoa, Madagascar.
2 Medical biology laboratory, UHC Fenoarivo, Madagascar.
3 UPFR Hematology, UHC-JRA Antananarivo, Madagascar.
4 Regional Blood Transfusion Center Haute Matsiatra Fianarantsoa, Madagascar.
5 Medical biology laboratory, UHC-JRB Antananarivo, Madagascar.
 
Research Article
World Journal of Biology Pharmacy and Health Sciences, 2023, 15(01), 030–034.
Article DOI: 10.30574/wjbphs.2023.15.1.0269
Publication history: 
Received on 07 May 2023; revised on 03 July 2023; accepted on 06 July 2023
 
Abstract: 
Introduction: Blood grouping appears to be simple to perform and interpret. Recommendations have been established to ensure the accuracy of the results. However, there are cases that create difficulties and may distort the result. We report a case of blood grouping problem with panagglutination of red blood cells found in the laboratory of University Hospital Center (UHC) Andrainjato Fianarantsoa Madagascar.
Case description: A 63-year-old woman of Asian origin was hospitalized in the Internal Medicine Department for fever and physical asthenia. She had a family history of beta-thalassemia minor. The blood count showed pancytopenia (regenerative anemia at 31 g/L, neutropenia at 1.7 G/L, thrombocytopenia at 34 G/L), with a probable presence of cold agglutinin (MCHC = 400 g/L). The blood grouping by globular test allowed to find a positive rhesus group AB, but the serum test was in favor of group A. The repeat of the haemogram and the blood grouping after incubation of the sample for one hour at +37° C made it possible to correct the MCHC and to objectify a positive blood group A rhesus respectively. The latter was confirmed by the pre-transfusion compatibility test with the tested isogroup blood and the transfusions performed were without incident.
Conclusion: Panagglutination of red blood cells, probably related to the presence of cold agglutinin in our case, represents one of the sources of blood grouping errors that should be avoided by the application of strict blood grouping rules.
 
Keywords: 
Blood grouping; Cold agglutinin; Compatibility; Panagglutination
 
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Copyright information: 
Copyright © 2023 Author(s) retain the copyright of this article. This article is published under the terms of the Creative Commons Attribution Liscense 4.0