Bombay blood group, also known as a rare blood type, is caused by a point mutation of the group H gene. The mutant variety, also known as the H gene, does not code for any protein. Thus, the sources of proteins called fucosyltransferases coded by the H gene or decrease in production. This protein catalyses the addition of L-fucose to the precursor chain to form the H antigen. Thus, in patients with Bombay blood group, the H antigen cannot be produced due to the absence of this protein.
Origin & story behind its terminology :
The name of this rare blood group is known as Bombay blood group since it was first discovered in Bombay (Mumbai) in India in 1952. The existence of the human H/H genetic polymorphism in it was first established by Dr. Y.M. bhende.
Most likely individuals having this group confined to Southeast Asia :
People with Bombay phenotype are mostly confined to Southeast Asia. In India, about 179 individuals with a frequency of 1 in 10,000 have the "Bombay blood group". Bombay blood group is a rare blood group, the phenotype of this group is also due to lack of H antigen on red cell membrane and anti-H in its serum. And most noticeably, it has been found that it fails to express any A, B or H antigens on their red cells or other tissues.
Caution in a hemolytic transfusion reaction:
The Bombay phenotype is extremely rare in Caucasians, with an incidence of one in 250,000. When individuals with the Bombay phenotype require a blood transfusion, they can receive only autologous blood or blood from another Bombay blood group. Transfusing blood group O red cells to them can result in a fatal hemolytic transfusion reaction.
Development of a hemolytic transfusion reaction:
A hemolytic transfusion reaction developed when reporting a rare Bombay blood group identified as an Au blood group highlights the importance of both forward and reverse typing in ABO blood grouping and standard cross-matching in hospital blood banks. and performs standard pretransfusion laboratory tests.
Accurate identification of bombay blood group:
Accurate and proper identification of the Bombay blood group helps to prevent adverse events related to blood transfusion and to encourage and practice safe transfusion.
Routine serum typing or reverse grouping confirmation:
Misdiagnosis ke karn utpan hone vali fatal hemolytic transfusion reaction se bachne ke liye suggest "routine serum typing or reverse grouping confirmation" with 'O' cell control in reverse grouping procedure in each transfusion medicine department or blood bank or blood donor centre be included.
Regular exercise essential to reduce risk:
Routine practice of fatal hemolytic transfusion reaction should be mandatory to reduce the risk.
Testing Methods of Bombay Blood Group :
The following are the limits set for blood transfusions:
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If such a person is given blood from A, B, AB or O blood group, that person's body may reject this type of blood which is a very risky condition.
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Bombay Blood Group Alert Network, needful can contact here for the quarries regarding availability of Bombay Blood Bank:
https://www.bombaybloodgroup.org?
This blood group can be caught only in the test of an automated machine:
Testing for Bombay blood group is not risky or easy to say, as it only shows O positive in a simple test. On getting tested in a small lab, the person is told that his blood group is positive. This blood group can be caught only in the examination of an automated machine. Whereas this blood contains H antigen.
Myanmar woman saved from death:
A 84-year-old woman needed blood for heart surgery in Myanmar in 2018. It was quite rare to find blood of his blood group. The blood of the woman's group was searched a lot in Myanmar but was left disappointed. Then a helping hand extended from miles away from India. Bangalore's Devanagare Blood Bank sent two units of rare Bombay blood group blood to Myanmar via courier. Only then the woman's life could be saved.
Some dilemmas are also associated with it.
Earlier in 2017, a unique case had come to the fore. For the first time in Colombia, a patient was found to be of Bombay blood group and for that blood was imported from Brazil. In Sri Lanka, a patient died in 2017 due to non-supply of this blood group on time.
Unavailability in world market :
Conclusion:
In conclusion, this is a notable case because it emphasises the importance of proper laboratory investigation for any suspicion of rare blood types as well as identification and management of the Bombay phenotype.