Immunology? C O N T E N T SDescriptionAcquired B state should be considered when the serum of a patient contains anti-B and the patient's RBC appears to be group AB with a weak B antigen. The acquired B phenotype arises through the modification of the A antigen by microbial enzymes called deacetylases. The enzymes modify cellular A immunodominant sugars (GalNAc) so they become more like the B sugar (Gal). A RBCs are the only group that exhibits acquired B activity in vivo. When present in sufficient numbers, acquired B antigens react with human anti-B in direct agglutination tests. While many examples of RBC with acquired B antigens react weakly with anti-B, some examples can be found that are agglutinated quite strongly. DiscussionTo confirm that group A1 RBCs carry the acquired B structure:
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