Abstract
The D antigen is highly immunogenic and may cause alloimmunization to occur after blood transfusion or pregnancy. Some RHD variant alleles express a D antigen that is missing one or more epitopes, thus putting a presumed D+ patient at risk for alloanti-D and hemolytic disease of the fetus and newborn. It is generally accepted that individuals who have a serologic weak D phenotype due to one of three alleles common in Caucasians, RHD*weak D types 1, 2, or 3, are not at risk for alloimmunization. In this study, blood samples from 46 obstetrics patients from a local health system were identified based on discrepant results between automated gel and manual tube testing (n = 20) or based on presentation with a serologic weak D phenotype (n = 26). RHD genotyping was performed using commercial and laboratory-developed tests. Of the 26 serologic weak D samples, 18 (69.2%) were found to carry alleles RHD*weak D type 1, 2, or 3. The remaining eight samples (30.8%) were found to carry partial D alleles. Of the 20 samples submitted because of D typing discrepancy, 7 (35%) carried alleles RHD*weak D type 1, 2, or 3, while 13 (65%) carried partial RHD alleles. This report summarizes the findings of one hospital system and its approach to integrating RHD genotyping into its assessment of risk of alloimmunization in obstetrics patients. It demonstrates that individuals with partial RHD alleles can present with serologic weak D phenotype, such that, without RHD genotyping, these individuals may not be identified as candidates for Rh immune globulin. The study also demonstrates that use of two methods (automated gel and tube testing) allows for identification of partial D cases that would otherwise be missed. I.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.