Background: ABO discrepancies occur whenever the results of red cell grouping and serum grouping are in disagreement. The reasons for discrepancies both clinical and technical have to be sorted out. Further analysis is essential to resolve such discrepancies. If discrepancies are encountered, the interpretation of the ABO grouping has to be delayed until the same has been resolved. The aim of the study was to resolve ABO discrepancies encountered, by serological work up.Methods: All cases of discrepant samples received between August 2014 and May 2016 at the Department of Transfusion Medicine, The Tamilnadu Dr. MGR Medical University, Chennai, India were analyzed to determine the etiology by serological workup.Results: A total of twenty-one samples were analyzed and resolved. Fifteen cases of Type IV discrepancy, two cases of Type II discrepancy, one case Type III discrepancy, one case Type I discrepancy and two cases of technical errors were identified.Conclusions: ABO discrepancies can be resolved serologically if properly worked up. As ABO blood grouping is indispensible in blood transfusion service, it is imperative to resolve such discrepancies before transfusion.

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Introduction: Haemophilia A is an X - linked recessive bleeding disorder caused by dysfunctional or decient production of coagulation Factor VIII. Development of antibodies against the exogenous Factor VIII is the major cause for refractoriness in the treatment of Haemophilia A. These antibodies are known as inhibitors. Aim: Estimation of prevalence of Factor VIII inhibitors in Haemophilia A patients by inhibitor screening assay. Determination of Factor VIII activity by Factor VIII assay in these patients and Quantify Factor VIII inhibitors by Bethesda assay. Methods: This study was carried out between January 2019 and December 2020. We studied 59 patients who were on “On-demand Plasmaderived factor VIII therapy” at the Haemophilia Treatment Centre- Royapetttah Government General Hospital, Chennai. Factor VIII level estimation, inhibitor screening assay and quantitative Bethesda assay were done at the Department of Transfusion Medicine, The Tamil Nadu Dr M.G.R Medical University. Results: Out of 59 patients screened, 31, 26 and 2 were diagnosed as severe, moderate and mild Haemophilia A respectively. Five of them developed inhibitors, two were newly diagnosed and three were known cases. The prevalence was 8.5%. All patients with inhibitors had <1% residual Factor VIII activity. Three had positive family history. By Bethesda Assay, two had high and three showed low titre Factor VIII inhibitors. Conclusion: The prevalence of Factor VIII inhibitor in our study is similar to other studies. We observed positive family history in majority of these patients. Since prophylactic factor VIII therapy delays inhibitor development, further study is recommended

The Direct Antiglobulin Test [DAT] is widely used in Immunohematological laboratory test because it is simple, quick and inexpensive test. It is performed when the presence of haemolysis and is the most important diagnostic tests for determining Immune Hemolytic Anemias. With this background this study was conducted, to evaluate the DAT positive cases Autoimmune Hemolytic Anemia [AIHA], along with antibody classes, severity and finally to perform elution studies to specify the antibody coated onto the red cells. 34 DAT positive AIHA cases with clinical and laboratory evidence of hemolysis were evaluated in this study. In these cases 25 warm Autoimmune Hemolytic Anemia [WAIHA]. 6 Cold Agglutinin Disease [CAD] and 3 Mixed AIHA. Our study suggests a significant association between the strength of DAT, the IgG class and subclass of Immunoglobulins either alone or in combination with other classes of immunoglobulins and/or complements. The specificity of auto and alloantibodies were identified by adsorption and elution techniques, which revealed exclusively anti-e in 6 cases of WAIHA and 5 cases with alloantibodies. The elution provides unbound RBCs for phenotyping and provide appropriate transfusion support for the needy patients. In our study revealed a strong association between the severity of hemolysis and the strength of DAT, the IgG and subclass (IgG 1 & IgG 3) of IgG Antibodies either alone or in combination with other classes of Antibodies and/or complements. The autoantibody specificity had anti-e in 6 cases of WAIHA and 5 cases had clinically significant alloantibodies. The positive DAT with falling hematocrit, jaundice appear to be clinically helpful in identifying alloantibodies.