{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T13:47:22Z","timestamp":1762868842171,"version":"3.40.5"},"reference-count":25,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2022,6,24]],"date-time":"2022-06-24T00:00:00Z","timestamp":1656028800000},"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":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Tn syndrome is an acquired form of polyagglutination arising from somatic mutations of hematopoietic stem cells. Tn red blood cells (RBCs) are agglutinable by naturally occurring anti\u2010Tn antibodies in most adult sera. Current ABO typing reagents are monoclonal and do not detect polyagglutination on forward typing. However, herein we describe a case of Tn activation that was suspected due to cross\u2010reactivity with a monoclonal anti\u2010A reagent.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design and Methods<\/jats:title><jats:p>A 63\u2010year\u2010old man with myeloproliferative neoplasm, who historically typed as group O, demonstrated unexpected mixed field reactivity with anti\u2010A reagent using a gel\u2010based method. However, manual tube testing was consistent with the patient's historical group O type.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Lectin testing demonstrated reactivity with <jats:italic>Salvia sclarea<\/jats:italic> and <jats:italic>Glycine soja,<\/jats:italic> but not <jats:italic>Arachis hypogea<\/jats:italic>. The patient's RBCs produced positive crossmatches with healthy donor sera, but reactivity was eliminated by ficin pretreatment of the RBCs. Ficin treatment also resolved typing discrepancies on gel\u2010based typing. No reactivity was noted using cord blood sera, and N antigen expression was diminished upon phenotyping. Tn activation was confirmed by detection of a novel 4\u2010nucleotide deletion (c.395\u2010398del) in exon 3 of <jats:italic>C1GALT1C1<\/jats:italic> resulting in a truncated glycosyltransferase.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This case of acquired Tn polyagglutination due to a novel mutation was first suspected from an ABO phenotyping discrepancy. It highlights the cross\u2010reactivity of anti\u2010A reagent with Tn antigen when tested on a common gel\u2010based method. Furthermore, the case demonstrates that review of patient history and test information can clarify discrepancies and guide resolution.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.16966","type":"journal-article","created":{"date-parts":[[2022,6,24]],"date-time":"2022-06-24T13:04:44Z","timestamp":1656075884000},"page":"1452-1456","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A case of Tn polyagglutination discovered by an <scp>ABO<\/scp> blood group discrepancy"],"prefix":"10.1111","volume":"62","author":[{"given":"Robert","family":"Achram","sequence":"first","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Center for Transfusion and Cellular Therapies, Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8727-1679","authenticated-orcid":false,"given":"Gregory A.","family":"Denomme","sequence":"additional","affiliation":[{"name":"Grifols Laboratory Solutions Inc.  San Marcos Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marianne A.","family":"Stef","sequence":"additional","affiliation":[{"name":"Grifols Laboratory Solutions Inc.  San Marcos Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thi Truc Anh","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Center for Transfusion and Cellular Therapies, Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bhavesh","family":"Delvadia","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Center for Transfusion and Cellular Therapies, Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louisa","family":"Thompson","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Center for Transfusion and Cellular Therapies, Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2543-991X","authenticated-orcid":false,"given":"Cassandra D.","family":"Josephson","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Center for Transfusion and Cellular Therapies, Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John D.","family":"Roback","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Center for Transfusion and Cellular Therapies, Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4909-7168","authenticated-orcid":false,"given":"H. Cliff","family":"Sullivan","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Center for Transfusion and Cellular Therapies, Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,6,24]]},"reference":[{"doi-asserted-by":"publisher","key":"e_1_2_6_2_1","DOI":"10.1016\/S0268-960X(99)90021-8"},{"key":"e_1_2_6_3_1","first-page":"121","article-title":"Necrotising enterocolitis and neuraminidase\u2010producing bacteria","volume":"35","author":"Seger R","year":"1980","journal-title":"Helv Paediatr Acta"},{"doi-asserted-by":"publisher","key":"e_1_2_6_4_1","DOI":"10.1111\/j.1365-2141.2008.07215.x"},{"doi-asserted-by":"publisher","key":"e_1_2_6_5_1","DOI":"10.1111\/tan.12900"},{"doi-asserted-by":"publisher","key":"e_1_2_6_6_1","DOI":"10.1038\/4371252a"},{"volume-title":"Technical manual","year":"2020","author":"Cohn CS","key":"e_1_2_6_7_1"},{"doi-asserted-by":"publisher","key":"e_1_2_6_8_1","DOI":"10.1016\/j.transci.2020.103013"},{"doi-asserted-by":"publisher","key":"e_1_2_6_9_1","DOI":"10.1111\/j.1423-0410.1973.tb03544.x"},{"doi-asserted-by":"publisher","key":"e_1_2_6_10_1","DOI":"10.1111\/j.1423-0410.1974.tb02684.x"},{"doi-asserted-by":"publisher","key":"e_1_2_6_11_1","DOI":"10.1182\/blood.V14.10.1079.1079"},{"key":"e_1_2_6_12_1","first-page":"569","article-title":"Acquired hemolytic anemia with polyagglutinability of erythrocytes by a new factor present in normal blood","volume":"73","author":"Moreau R","year":"1957","journal-title":"Bull Mem Soc Med Hop Paris"},{"doi-asserted-by":"publisher","key":"e_1_2_6_13_1","DOI":"10.1186\/1752-1947-5-8"},{"doi-asserted-by":"publisher","key":"e_1_2_6_14_1","DOI":"10.1016\/S0925-4439(99)00069-1"},{"doi-asserted-by":"publisher","key":"e_1_2_6_15_1","DOI":"10.4103\/0973-6247.150970"},{"doi-asserted-by":"publisher","key":"e_1_2_6_16_1","DOI":"10.1182\/blood.V54.1.30.30"},{"key":"e_1_2_6_17_1","first-page":"113","article-title":"A patient with Tn syndrome associated with myelodysplastic syndrome showed abnormal glycophorin B","volume":"58","author":"Kamesaki T","year":"1993","journal-title":"Int J Hematol"},{"doi-asserted-by":"publisher","key":"e_1_2_6_18_1","DOI":"10.1172\/JCI111730"},{"doi-asserted-by":"publisher","key":"e_1_2_6_19_1","DOI":"10.1007\/BF01883318"},{"doi-asserted-by":"publisher","key":"e_1_2_6_20_1","DOI":"10.1016\/j.molimm.2020.02.005"},{"doi-asserted-by":"publisher","key":"e_1_2_6_21_1","DOI":"10.1371\/journal.pone.0218575"},{"doi-asserted-by":"publisher","key":"e_1_2_6_22_1","DOI":"10.1111\/j.1537-2995.1972.tb00020.x"},{"doi-asserted-by":"publisher","key":"e_1_2_6_23_1","DOI":"10.1111\/j.1365-2141.1971.tb02705.x"},{"key":"e_1_2_6_24_1","article-title":"Applied blood group serology","author":"Issitt PD","year":"1998","journal-title":"Montgomery Sci"},{"doi-asserted-by":"publisher","key":"e_1_2_6_25_1","DOI":"10.21307\/immunohematology-2019-347"},{"doi-asserted-by":"publisher","key":"e_1_2_6_26_1","DOI":"10.4103\/0973-6247.172180"}],"container-title":["Transfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.16966","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/trf.16966","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.16966","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T12:54:28Z","timestamp":1692276868000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/trf.16966"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,24]]},"references-count":25,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2022,7]]}},"alternative-id":["10.1111\/trf.16966"],"URL":"https:\/\/doi.org\/10.1111\/trf.16966","archive":["Portico"],"relation":{},"ISSN":["0041-1132","1537-2995"],"issn-type":[{"type":"print","value":"0041-1132"},{"type":"electronic","value":"1537-2995"}],"subject":[],"published":{"date-parts":[[2022,6,24]]},"assertion":[{"value":"2021-11-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-05-17","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-06-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}