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Blood group discrepancy: Is it Group I or Group III?

ABO blood group system is the most crucial blood group system in terms of blood transfusion and transplantation capable of causing fatal reactions. In the determination of ABO blood group, two methods – cell grouping and serum grouping – are performed as a double check. Discrepancies between these two methods often occur and are classified arbitrarily into Group I due to weak or absent antibodies causing problems in serum grouping (as may be seen in the elderly, new‐born patients and immune‐deficient or immune‐compromised patients), Group II due to weak or absent antigens causing problems in cell grouping (weak antigens, subgroups of A and B), Group III due to abnormal plasma proteins causing rouleaux formation as in multiple myeloma and Group IV due to miscellaneous reasons like panagglutination.[1,2]