<abstract xmlns="http://www.w3.org/1999/xhtml"><p>Antibodies, such as anti-Rh18 (Hr/Hr<sup>S</sup>), that react with the common products of <italic>RHCE</italic> can cause HDN as well as severe hemolytic transfusion reactions. Individuals with anti-Rh18 antibodies can have different <italic>RHCE</italic> genetic backgrounds; therefore, sera and RBCs from these individuals may cross-react. In these situations, genotyping may be the best method to determine compatibility. We report a 26-year-old pregnant Puerto Rican woman who presented at 31 weeks’ gestation with anti-E and anti-Rh18 in her serum. No potential donors were identified among family members or within the American Rare Donor Program; therefore, a unit of the patient’s RBCs was collected one week before her planned caesarian section. To improve our ability to supply blood for this patient in the future, molecular testing was performed. The patient was found to be homozygous for an RH haplotype in which a variant <italic>RHD*DAR</italic>, is linked to a variant <italic>RHCE*ceAR</italic>. The <italic>DAR-ceAR</italic> haplotype has been described in Dutch-African populations, but this is the first report of an individual self-identified of Hispanic ethnicity. This case report demonstrates the clinical importance of molecular testing of patients with rare Rh phenotypes. <italic><bold>Immunohematology</bold></italic><bold>2006;22:132–135.</bold></p></abstract>

Antibodies, such as anti-Rh18 (Hr/HrS), that react with the common products of RHCE can cause HDN as well as severe hemolytic transfusion reactions. Individuals with anti-Rh18 antibodies can have different RHCE genetic backgrounds; therefore, sera and RBCs from these individuals may cross-react. In these situations, genotyping may be the best method to determine compatibility. We report a 26-year-old pregnant Puerto Rican woman who presented at 31 weeks’ gestation with anti-E and anti-Rh18 in her serum. No potential donors were identified among family members or within the American Rare Donor Program; therefore, a unit of the patient’s RBCs was collected one week before her planned caesarian section. To improve our ability to supply blood for this patient in the future, molecular testing was performed. The patient was found to be homozygous for an RH haplotype in which a variant RHD*DAR, is linked to a variant RHCE*ceAR. The DAR-ceAR haplotype has been described in Dutch-African populations, but this is the first report of an individual self-identified of Hispanic ethnicity. This case report demonstrates the clinical importance of molecular testing of patients with rare Rh phenotypes. Immunohematology2006;22:132–135.

Serologic and molecular genetic management of a pregnancy complicated by anti-Rh18

Immunohematology

Antibodies, such as anti-Rh18 (Hr/HrS), that react with the common products of RHCE can cause HDN as well as severe hemolytic transfusion reactions....

Serologic and molecular genetic management of a pregnancy complicated by anti-Rh18

Published Online: Apr 15, 2020

Page range: 132 - 135

DOI: https://doi.org/10.21307/immunohematology-2019-370

© 2006 R.L. Haspel, et al., published by Sciendo