Hi Virginia,
the Bombay phenotype erythrocytes lack the H antigen, on top of which the "normal" AB0 blood type sugar chains are normally added. Therefore, Bombay type erythrocytes seem to be of blood group 0. However, these people will have antibodies against this H antigen, next to the normal anti-A and anti-B antibodies found in blood group 0 individuals (this is why you should ALWAYS look for AB0 antibodies in every typing, including blood group A1, A2, B, and 0 test cells!).
If you transfuse "normal" blood group 0 erythrocytes into a Bombay type patient, he/she most likely will have such anti-H-antibodies, which then will lead to an acute type intravenous hemolysis. VERY DANGEROUS! In case of such a hemolysis, you will eventually find some erythrocytes which are bigger than usual - shortly before they burst...
I am not aware of another link between Bombay type blood and macrocytosis - however, there surely are more sophisticated experts in the field of Bombay type blood...
Thank you for your answer, Julian! This is not my field, but I have curiosity about this subject. Do you know what techniques are used to determine whether a person has any allele h. Are these techniques used in common laboratories?
Hi Virginia,
maybe you´ll find those two links below helpful in any way (I´d first read the wiki one, and then go on to the more sophisticated ncbi article) !
At our lab (we´re doing some 10.000 typings a year), we only "screen" for anti-H-antibodies by using blood group 0 erythrocytes in the test for AB0 antibodies. So, if there were any anti-H-antibodies present (e.g., due to a Bombay type blood), the 0 erythrocytes would be agglutinated in the test. We´re doing solid phase assays on a lab roboter, but you could use simple wells for manual typing as well. One drop of erythrocyte solution, two drops of serum, there you are...
You cannot look for h antigens, there are none...the antigen is called H. However, if you fail to express the H antigen, you are genetically of an hh type!
So, you could do PCR in order to determine whether or not there is an H gen with some sort of stop mutation or whatever - serologically, this does not matter. If there is no H, there won´t be A or B antigens!
Hope that helps!
http://www.ncbi.nlm.nih.gov/books/NBK2268/
https://en.wikipedia.org/wiki/Hh_blood_group
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