0

Ana Heully,
Alexis Threeton, &
Courtney Zahn
Pathophysiology

BLOOD: GROUPS AND

RELATED DISEASES

Running Head: BLOOD: GROUPS AND RELATED DISEASES

Blood: Groups and Related Diseases

Ana Heully
Alexis Threeton
Courtney Zahn
Our Lady of the Lake College

Running Head: BLOOD: GROUPS AND RELATED DISEASES

Abstract
Blood is complex, vital, and displays many similarities from person to person. All blood
is composed of plasma and formed elements, which include red blood cells, white blood
cells, and platelets. It is on the surface of the red blood cells that differences in blood can
be observed. These differences are A and B antigens, which have paved the way for the
classification of blood into groups.

The ABO and Rh classification systems have

improved the safety of blood transfusions, and have also provided explanations for
certain disorders and diseases. These blood groups have played a role in certain diseases
such as hemolytic disease of a newborn, anemia, and polycythemia.

Running Head: BLOOD: GROUPS AND RELATED DISEASES

Blood: Groups and Related Diseases
Blood is essential to life, growth, and health, transporting crucial elements
including oxygen and nutrients throughout the body, and eliminating waste such as
carbon dioxide and ammonia. Blood also regulates body temperature and plays a crucial
role in immunity. This vital fluid consists of two major components: plasma and formed
elements. Plasma is the liquid component of blood that transports nutrients, hormones,
electrolytes, and proteins throughout the body. The formed elements include platelets,
white blood cells, and red blood cells. Plasma cells produce antibodies, which are
proteins that recognize and neutralize foreign substances, known as antigens, following
an immune response. Platelets, or thrombocytes, are cell fragments essential to blood
clotting (American Society of Hematology, 2015). White blood cells (leukocytes) are the
immune system cells, which function to identify and eliminate harmful substances in the
body. Red blood cells, erythrocytes, function primarily to transport oxygen from the
lungs to the body tissues and remove carbon dioxide from the tissues. Red blood cells
are the most abundant cell in the body, each containing 280 million hemoglobin
molecules. Hemoglobin is a protein rich in iron, which is responsible for the red color of
blood, and functions to transport oxygen and carbon dioxide throughout the body as well
as to regulate blood pressure and blood flow. Blood is complex, vital to survival, and
similar from person to person. Despite these similarities, analysis of blood under a
microscope led to the discovery that there are also differences in the red blood cells of
blood (Tortora & Derrickson, 2009).
The differences in blood are associated with microscopic markers known as
antigens, which are located on the surface of red blood cells. Antigens are composed of

Running Head: BLOOD: GROUPS AND RELATED DISEASES

glycolipids and glycoproteins, and are the basis for the classification of blood into
groups. There are more than twenty blood groups and over a hundred antigens on the
surface of red blood cells. The two major blood group systems are the ABO and Rh
systems, which are the most commonly used during blood transfusions. The antigens on
the surface of red blood cells were observed by Austrian scientist, Karl Landsteiner,
during a time when death as a result of a blood transfusion was common. Blood
transfusions involve the addition of whole blood or components of blood into a persons
bloodstream or bone marrow. Not all blood groups are compatible, and the mixing of
incompatible blood from two different people can cause agglutination, or blood
clumping. Landsteiner discovered that the agglutination was an antigen-antibody
complex, which resulted from a transfusion of incompatible blood. The antigen-antibody
complex forms as a result of the antibodies in the plasma of the recipient binding to the
antigens on the surface of the donors red blood cells (Tortora & Derrickson, 2015).
Landsteiners discovery and his involvement in the identification and differentiation of
the ABO and Rh blood groups has improved the quality and safety of blood transfusions.
The antigens discovered on the surface of red blood cells were named A and B by
Landsteiner. There are four major blood groups which are determined by the presence or
absence of A or B antigens: A, B, AB, or O. In addition to the A and B antigens, there is a
third antigen called the Rh factor. The Rh group can be positive or negative depending
on the presence or absence of the Rh factor (Blood Types, 2014).

Group A blood has only the A antigen on the surface of the red blood cells and B antibody
in the plasma. Group A is able to donate red blood cells to group A and group AB (Blood

Running Head: BLOOD: GROUPS AND RELATED DISEASES

Types, 2014). Recent studies have shown that people with group A blood are at greater
risk of having high stress levels. This is
because people with group A blood, have
higher levels of cortisol, the stress hormone.
When the adrenal gland releases large
amounts of cortisol into the blood, the result
is an acute stress response (Weller, 2014).
(Scott, 2012) 1: ABO and Rh Blood Groups
and their Surface Antigens

People with group B blood have the

B antigen on red blood cells and A antibody in the plasma. This blood group is able to
donate to other people with group B blood and to group AB (Blood Types, 2015). There
have been studies that show that individuals with group B blood are more likely to
contract diseases such as polio, lupus, and rare disorders such as Lou Gehrigs disease.
They suffer from the highest incidence of bladder infections, urinary tract infections and
are more prone to viral diseases when their immune system is compromised (Chambers,
2011).
There have been studies that show that one of the most significant disease
associations described for non-O versus O subjects is susceptibility to arterial and venous
thromboembolism. The elevated risk of venous thromboembolism in non-O blood groups
is related to the increased levels of von Willebrand factor and factor VIII proteins
(Anstee, 2010).
Type O blood does not contain any antigens on the surface of the red blood cells,
but has anti-A and anti-B antibodies in the plasma. This makes type O blood a universal
donor, which means it is capable of giving blood to any of the other blood types (ONeil,

Running Head: BLOOD: GROUPS AND RELATED DISEASES

2010). Type O negative blood is unique because it can be transferred to any patient
needing blood. 6.6% of humans have O negative blood, so there is always a need for this
type of blood group. O negative blood is commonly given to newborns with underdeveloped immune systems (English, 2013). Sometimes O positive blood can be
substituted for O negative blood. O positive blood is characterized by presence of a Rhpositive antigen on the surface of the cell and is the most common of blood types.
(English, 2013).
Type AB blood has no antibodies in the plasma and both A and B antigens on the
surface of the red blood cell. A person with type AB blood can only donate to others of
the same blood type, but can receive blood from any blood group. People with type AB
blood are known as universal recipients (ONeil, 2010). The universal plasma donor has
type AB positive blood type. The AB blood group is the least common blood group, and
medical facilities are always in need of AB plasma (English, 2013).
The Rh blood group is extremely important, especially regarding the health of
newborn babies. Rh + blood is more common than Rh blood, and has differing
characteristics. People with Rh + blood can only receive Rh + blood, but can donate to
people who are Rh + or Rh - . People who are Rh can only donate to other people with
Rh blood, but can receive Rh + or Rh blood. The effects of mismatched blood on a
newborn can be devastating.
Hemolytic disease of the newborn (HDN) is a dangerous red blood cell disease in
which the mothers antibodies attack the red blood cells of the newborn. The disease
develops when IgG antibodies produced by the mother, are passed to the newborn
through the placenta. The red blood cells in the fetus are broken down causing anemia.

Running Head: BLOOD: GROUPS AND RELATED DISEASES

This condition is caused by the mother and fetus not having the same blood type,
normally a Rh-negative mother and a Rh-positive baby (Lee, 2013). The mothers body
notices the difference in blood types and begins to build up antibodies against the fetuss
blood type. This condition becomes more severe when the mother becomes pregnant with
another Rh-positive baby because those antibodies that are produced begin attacking the
second baby. This condition gives rise to many symptoms, one being hemolysis.
Hemolysis is the condition where the red cells are being broken down so the baby starts
to lose blood. This condition will then cause elevated levels of bilirubin, causing
jaundice. Jaundice results in the yellowing of the newborns skin and eyes. If the jaundice
is severe enough the newborn could obtain kernicterus, caused by hyperbilirubinemia,
this condition can give rise to brain dysfunction, or death, because of the excess bilirubin
levels building up in the brain (Gersten, 2014).
There are many ways to diagnose hemolytic disease of the newborn. Initial tests
include a series of blood tests including a complete blood count (CBC), bilirubin levels,
and blood typing. Secondly, the doctor would check the newborn for an enlarged liver or
spleen. Lastly, the doctor would check for fluid throughout the newborns tissue,
especially in the lungs and around the heart. The preventative measures that OB-GYNs
use is the Rhogam injection. This injection is able to take out the fetuss Rh-positive IgG
molecules that have entered the mothers placenta. After birth, if the newborn has this Rh
disease, then there are a number of treatments that are widely used to correct it. A doctor
could give the newborn a blood transfusion for the severe anemia, exchange transfusion
where the newborns is given fresh blood to replace the damaged blood, intravenous fluids

Running Head: BLOOD: GROUPS AND RELATED DISEASES

for low blood pressure, intravenous immunoglobulin, or phototherapy for jaundice (Lee,
2013).
Another disease commonly caused by blood groups is anemia. Anemia has many
forms and is linked to numerous diseases. The most common form of anemia is iron
deficiency anemia. Iron deficiency anemia is a blood disorder where there are a
decreased number of healthy red blood cells caused by insufficient iron. Without the
required amount of iron in the blood your body cannot produce enough the substance that
allows the red blood cells to carry oxygen systemically. There are many symptoms
associated with this blood disorder such as fatigue, shortness of breath, cold hands and
feet, etc. Some causes of this disorder include blood loss, a lack of iron in ones diet, the
inability to absorb iron, or pregnancy (Marks, 2014). Red blood cells contain iron, so if a
patient were to lose blood they would also lose iron as well. The body gets a large
amount of iron of the food that we consume everyday such as chicken, steak, broccoli,
and so on. If a person is not consuming enough iron in their diet then the body will
become iron deficient. Some complication could arise with this blood disorder including
heart problems and growth problems. Iron deficiency could potentially lead to an increase
in the heart rate because the heart must pump harder and faster to compensate for the lack
of oxygen throughout the body (Pruthi, 2010). To successfully diagnose iron deficiency
anemia a physician must run certain tests. Red blood cell size and color is one of the tests
a physician might perform because normally a patient with iron deficiency anemia will
have smaller and paler red blood cells. The physician will also check the patients
hematocrit to check the percentage of red blood cells the patient contains in their body.
Lastly, the doctor will check the patients hemoglobin levels and iron levels. Iron

Running Head: BLOOD: GROUPS AND RELATED DISEASES

deficiency is curable and easy to treat. Most patients are put on iron supplements to raise
their iron levels and put on an iron sufficient diet (Marks, 2014).
Sickle cell anemia is an inherited disease form of anemia. This condition causes
the shape of red blood cells to change. A normal red blood cell is round and flexible
whereas a person with sickle cell anemia has sickle, or crescent moon, shaped red blood
cells and the cells become sticky and rigid. This allows the red blood cells to become
stuck the vessels wall, which will then blood the vessel so there is no blood flow in or out
and a lack of oxygen throughout the body (Berge, 2010). Some symptoms associated
with sickle cell anemia are as followed pain, frequent infection, vision problems, swollen
hands and feet, and delayed growth. There are tests that are run on a patients blood to
confirm if one has sickle cell anemia. One test is to check for hemoglobin S, this is a
defective form of hemoglobin associated with sickle cell anemia. Another way to confirm
sickle cell anemia is to look at the patients blood cells under the microscope for any
deformities or abnormalities in the red blood cells (Berge, 2010). As of now there is no
cure for sickle cell anemia, but there is a list of treatments that can be given to the patient
for pain and other problems that arise from sickle cell anemia. A potential cure for sickle
cell anemia is for the patient to undergo a bone marrow transplant, but finding donors are
very difficult and this procedure has some risks, including death. Other treatments offered
to people with sickle cell anemia include antibiotics to prevent infection and pain
medications (Berge, 2010).
While anemia is the decreased amount of healthy red blood cells, polycythemia is
the increased amount of red blood cells. There are two different types of polycythemia:
primary and secondary. Primary polycythemia is an increase in red blood cells due to a

Running Head: BLOOD: GROUPS AND RELATED DISEASES

problem in red blood cell production. Secondary polycythemia is an increase in red blood
cells that occurs because of underlying conditions that promote red blood cell production.
In general the symptoms for polycythemia include weakness, fatigue, headache, bruising,
and joint pain (Sheil, 2012). Polycythemia can be diagnosed in a number of ways. First a
doctor would order a complete blood count to check for the concentration of red blood
cells. A physician might also order an EKG or lung x-ray to see if there is an underlying
cause. The treatment for polycythemia mainly relies on the cause. Phlebotomy and
medication to reduce the production of red blood cell are the main treatments used for
people with primary polycythemia. In a patient with secondary polycythemia the
physician would treat the underlying cause along with an oxygen supplement (Sheil,
2012).
Blood and its associated functions make it one of the most complex and essential
components of the human body. The discovery of surface antigens on red blood cells
allowed for the classification of the ABO and Rh blood groups, which have improved the
safety of transfusions. The association of certain blood groups to various diseases and
disorders has just begun. Further research and time will prove whether or not a major
relationship between the two exists.

References
ABO System. (n.d.). Retrieved from http://anthro.palomar.edu/blood/ABO_system.htm.

Running Head: BLOOD: GROUPS AND RELATED DISEASES

American Society of Hematology (2015). Blood basics. Retrieved April 11, 2014, from
http://www.hematology.org/Patients/Basics/.
Anstee, D. (2010, January 10). The relationship between blood groups and disease.
Retrieved April 10, 2015, from
http://www.bloodjournal.org/content/115/23/4635?sso-checked=true#sec-7
Blood Types. (2014, March 17). Retrieved April 9, 2015, from
http://www.redcrossblood.org/learn-about-blood/blood-types
Berge, K. (2010, September 13). Sickle cell anemia. Retrieved April 23, 2015, from
http://www.mayoclinic.org/diseases-conditions/iron-deficiencyanemia/basics/symptoms/con-20019327
Chambers, W. (2011, January 20). What's My Blood Type | Blood Type B. Retrieved
April 10, 2015, from http://whatsmybloodtype.org/type_b.html
English, D. (2013, June 6). Your AB+ Blood Is Important. Retrieved April 23, 2015, from
http://thebloodconnection.org/about-blood/blood-education/blood-types/onegative/
English, D. (2013, June 6). Your O+ Blood Is Important. Retrieved April 23, 2015, from
http://thebloodconnection.org/about-blood/blood-education/blood-types/onegative/
English, D. (2013, June 6). Your O- Blood Is Important. Retrieved April 23, 2015, from
http://thebloodconnection.org/about-blood/blood-education/blood-types/onegative/
Gersten, T. (2014, February 24). Hemolytic anemia. Retrieved April 23, 2015, from
http://www.nlm.nih.gov/medlineplus/ency/article/000571.htm

Running Head: BLOOD: GROUPS AND RELATED DISEASES

Lee, K. (2013, October 29). Hemolytic disease of the newborn. Retrieved April 23, 2015,
from http://www.nlm.nih.gov/medlineplus/ency/article/001298.htm
Marks, J. (2014, March 14). Iron Deficiency Symptoms, Causes, Treatment - How is iron
deficiency diagnosed? - MedicineNet. Retrieved April 23, 2015, from
http://www.medicinenet.com/iron_and_iron_deficiency/page4.htm
O'Neil, D. (2010, October 27). ABO Blood Types. Retrieved April 23, 2015, from
http://anthro.palomar.edu/blood/ABO_system.htm
Pruthi, S. (2010, April 20). Iron deficiency anemia. Retrieved April 23, 2015, from
http://www.mayoclinic.org/diseases-conditions/iron-deficiencyanemia/basics/symptoms/con-20019327
Tortora, G., & Dernick R. (2009). Principles of Anatomy and Physiology. The
cardiovascular system: the blood. 12th ed. Pages 689-711. John Wiley & Sons, Inc.
Weller, C. (2014, September 24). 6 Things Your Blood Type Can Say About Your Health.
Retrieved April 9, 2015, from http://www.medicaldaily.com/6-ways-blood-typecan-influence-personal-health-mild-stress-cancer-304518