Reverse grouping (testing the patient's serum against known A1 and B reagent red cells) indirectly serves as a functional check of the patient's ability to produce normal levels of ABO antibodies, which are immunoglobulins (primarily IgM). If a patient has normal immune function, the expected agglutination pattern (e.g., anti-B in a type A patient) will be strong. Weak or absent reactions in reverse grouping, in the face of a clear forward grouping result, can be an important clue to underlying immunodeficiency, immunosuppression, extreme age (very young or very old), or certain hematologic malignancies like chronic lymphocytic leukemia (CLL). Thus, an unexpected negative in reverse grouping prompts investigation into the patient's clinical condition.

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Zambia

• Naomi Miselo – 31 pts

• Visual Pathway Lesions
• Positive and Negative Symptoms
• Hallucinations and Delusions
• Antipsychotic Medications
• Emergency: Environmental Emergencies