Resolving Serological Blood Group Discrepancy and Providing Transfusion Support in a Patient of Mixed Auto Immune Hemolytic Anemia: A Case Report

ABO grouping should include both forward and reverse grouping procedure, and results of two procedures should agree with each other. Mixed autoimmune hemolytic anemia (AIHA) is defined as presence of both warm and cold autoantibodies. Approximately 20% of AIHA are associated with cold-reactive antibodies. Warm autoantiboies are responsible for 48-70% of AIHA cases. About half of patients are termed idiopathic without any underlying causes. Secondary cases are associated with underlying diseases or with certain drugs. Diagnosis is based on detection of autoantibodies by monospecific Direct antiglobulin test (DAT) showing positive reaction on IgG and Complement C3d and presence of cold agglutinins. We report a case of mixed AIHA in 35 yr old lady who had severe anemia, blood group discrepancy, crossmatch incompatibility. We provided 2 units of Best matched blood (least incompatible) and she responded to corticosteroids. To our knowledge a careful communication between the transfusion services and clinicians can avoid unnecessary blood transfusions in such cases especially in clinically responding patients.