{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T02:05:59Z","timestamp":1747188359271,"version":"3.40.5"},"reference-count":24,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,1,21]],"date-time":"2021-01-21T00:00:00Z","timestamp":1611187200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>We report a case of apparent mother\u2010child ABO group noninheritance. A Caucasian mother initially typed as group O and her infant group AB. Investigation ruled out preanalytical causes such as mislabeled samples and in vitro fertilization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>Red blood cells were characterized by routine serologic testing. Genomic data were analyzed by targeted polymerase chain reaction\u2013restriction fragment length polymorphism and Sanger sequencing. Transferase structures were modeled using PyMOL molecular visualization software.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Serologic testing initially demonstrated the mother was group O, father group AB, and infant group AB. Further testing of the maternal sample with anti\u2010A,B demonstrated weak A expression. Molecular testing revealed the maternal sample had an <jats:italic>ABO*O.01.01<\/jats:italic> allele in trans to an <jats:italic>A<\/jats:italic> allele, <jats:italic>ABO*AW.29<\/jats:italic> (c.311T&gt;A, p.Ile104Asn), determined by gene sequencing. The sample from the infant carried the same <jats:italic>ABO*AW.29<\/jats:italic> allele in trans to a <jats:italic>B<\/jats:italic> allele, <jats:italic>ABO*B.01<\/jats:italic>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p><jats:italic>ABO<\/jats:italic> genotyping revealed an A transferase encoded by <jats:italic>ABO*AW.29<\/jats:italic>, with apparent variable activity. Although A antigen expression is well known to be weak in newborns, it was robust on the red blood cells (RBCs) of the AB infant and undetectable with anti\u2010A on the mother. Variable expression of weak subgroups may reflect competition or enhancement by a codominant allele, as well as glycan chain maturation on red cells. Previous examples in group AB mothers with A<jats:sub>weak<\/jats:sub> infants suggested that the decreased expression is primarily due to glycan immaturity. To our knowledge, this is the first reported case of the <jats:italic>ABO*AW.29<\/jats:italic> allele presenting with weak A expression in a group A<jats:sub>weak<\/jats:sub> mother and robust A expression in a group AB infant, suggesting the in trans allele is an important factor in determining transferase activity and may override age\u2010related effects.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.16263","type":"journal-article","created":{"date-parts":[[2021,1,21]],"date-time":"2021-01-21T18:44:05Z","timestamp":1611254645000},"page":"979-985","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["ABO maternal\u2010child discordance: Evidence of variable allelic expression and considerations for investigation"],"prefix":"10.1111","volume":"61","author":[{"given":"Tristan F.P.","family":"McKnight","sequence":"first","affiliation":[{"name":"Department of Pathology University of California San Diego  La Jolla California 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