Original Articles

A discrepancy of blood group A with missing antigen in anorectal malformation patient at Dr. Wahidin Sudirohusodo Hospital, Makassar, Indonesia

Yohanes Kusumo Adi Arji Atmanto , Raehana Samad, Rachmawati Muhiddin, Mansyur Arif

Yohanes Kusumo Adi Arji Atmanto
Medical Specialist Program of Clinical Pathology, Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia. Email: adi.pk.unhas@gmail.com

Raehana Samad
Department of Clinical Pathology, Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia ; Regional Technical Unit for Blood Transfusion of South Sulawesi Province, Makassar, Indonesia

Rachmawati Muhiddin
Department of Clinical Pathology, Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia ; Clinical Pathology Laboratory Installation of Dr. Wahidin Sudirohusodo Hospital, Makassar, Indonesia

Mansyur Arif
Department of Clinical Pathology, Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia ; Clinical Pathology Laboratory Installation of Dr. Wahidin Sudirohusodo Hospital, Makassar, Indonesia ; Clinical Pathology Laboratory Installation of Universitas Hasanuddin Hospital, Makassar, Indonesia ; Clinical Pathology Laboratory Installation of Ibnu Sina Hospital, Makassar, Indonesia
Online First: October 12, 2021 | Cite this Article
Atmanto, Y., Samad, R., Muhiddin, R., Arif, M. 2021. A discrepancy of blood group A with missing antigen in anorectal malformation patient at Dr. Wahidin Sudirohusodo Hospital, Makassar, Indonesia. Indonesia Journal of Biomedical Science 15(2): 121-125. DOI:10.15562/ijbs.v15i2.322


Background: Blood group discrepancy is a discrepancy in the results of the cell grouping with serum grouping examination. The source of discrepancy is from technical errors or a patient's medical status such as age, disease, history of blood transfusion and medication, pregnancy. This case study aims to evaluate a discrepancy of blood group A with missing antigen in anorectal malformation patient at Dr. Wahidin Sudirohusodo Hospital, Makassar, Indonesia

Case Presentation: A male baby, 6 months 19 days old, was unable to defecate since birth post-colostomy. Physical examination reveals anemia. A routine blood test showed a hemoglobin level of 8.8 g/dL. The diagnosis was high position anorectal malformation post colostomy suspect Hirschsprung Disease, with 110 cc Packed Red Cell (PRC) transfusion plan. A routine pre-transfusion procedure was performed. It was found a discrepancy of blood group A with missing antigen.  Crossmatching with blood groups O and A both gave compatible results. Examination of peripheral blood smear after PRC blood group A transfusion found no signs of hemolytic.

Conclusion: Blood group discrepancy, in this case, was due to missing antigen, which was caused by the possibility of gastrointestinal bacterial infection.

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