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Hemolytic anemia is associated with Rhnull but not with Bombay blood. Preliminary evidence indicates that the Rh antigen which is lipoprotein in nature occupies sites on the red cell membrane surface. The absence of the lipoprotein which carries the Rh antigens in Rhnull blood compromises the integrity of the membrane and the result is a mild hemolytic anemia. Recent findings indicate that the ABO glycoprotein molecule isolated from erythrocytic membranes is so oriented that its oligosaccharide‐rich N‐terminal end is exposed above the surface of the membrane and its C‐terminal end remains in the interior of the membrane. The absence of ABO and H determinants in Bombay blood does not affect membrane integrity, so that Bombay blood is not associated with hemolytic anemia.
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Levine et al. (1973) studied this question.
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