Otwarty dostęp
Transfusion support for a woman with RHD*09.01.02 and the novel RHD*01W.161 allele in trans
, oraz | 29 kwi 2022
O artykule
Article Category: Case Report
Data publikacji: 29 kwi 2022
Zakres stron: 17 - 24
DOI: https://doi.org/10.21307/immunohematology-2022-036
© 2022 K. Srivastava, M.U. Bueno, and W.A. Flegel, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Red cell genotyping of the RHD gene
| Test | Allele 1 | Allele 2 |
|---|---|---|
| RBC-FluoGene D weak/variant | Possible |
|
| wRHD BeadChip | Possible |
|
| Nucleotide sequencing | ||
| Allele recognized | Known | Novel |
| Nucleotide sequence (GenBank) | KF712273 | MT980847 |
| Amino acid change(s) | T201R, F223V, I342T | I204K |
| Serologic weak D phenotype15 | DAR1.2 (weak D 4.2.2)18 | Weak D type 161 |
| ISBT terminology16 | ||
Routine serology
| Test | Result |
|---|---|
| ABO group | AB (mixed-field agglutination for A)* |
| RhD phenotype | Serologic weak D phenotype† |
| RhCE phenotype | C+E–c+e+ |
| Antibody detection test | Negative |
| Direct antiglobulin test | Negative |
Serologic testing with panels of anti-D
| D variant and serologic reaction strength* |
|||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Study sample |
Control samples |
||||||||||||
| Monoclonal anti-D† |
Weak D type |
||||||||||||
| Clone | Isotype | epD | Patient CDe/cDe | 19‡ CDe/cde | 1 CDe/cde | 4.0§ cDe/cde | 4.1 cDe/cde | 4.2.2¶ cDe/cde | 45 CDe/cde | 64 cDe/cde | 88 cDE/cde | D+ cDe/cde | D– cde/cde |
| LHM76/58 | IgG1λ | 8.1 | 4+ | + | 4+ | 4+ | 4+ | 3+ to 4+ | 4+ | 4+ | 4+ | 4+ | 0 |
| LHM76/59 | IgG1 | 15.1 | 4+ | + | 4+ | 4+ | 4+ | 3+ to 4+ | 4+ | 4+ | 4+ | 4+ | 0 |
| LHM174/102 | IgG3κ | 1.2 | 2+ | + | 0 | 0 | 0 | 0 | 4+ | 2+ | 1+ | 4+ | 0 |
| LHM50/2B | IgG1λ | 6.3 | 4+ | NT | 4+ | 4+ | 4+ | 3+ to 4+ | 4+ | 4+ | 4+ | 4+ | 0 |
| LHM169/81 | IgG3κ | 1.1 | 4+ | + | 4+ | 4+ | 4+ | 2+ to 3+ | 4+ | 4+ | 4+ | 4+ | 0 |
| ESD1 | IgG1κ | 4.1 | 4+ | NT | 4+ | 4+ | 4+ | 3+ to 4+ | 4+ | 4+ | 4+ | 4+ | 0 |
| LHM76/55 | IgG1κ | 3.1 | 4+ | + | 4+ | 4+ | 4+ | 3+ to 4+ | 4+ | 4+ | 4+ | 4+ | 0 |
| LHM77/64 | IgG1κ | 9.1 | 4+ | NT | 4+ | 4+ | 4+ | 3+ to 4+ | 4+ | 4+ | 4+ | 4+ | 0 |
| LHM70/45 | IgG1λ | 1.2 | 3+ | + | 3+ | 3+ | 3+ | 0 to 2+ | 3+ | 3+ | 3+ | 4+ | 0 |
| LHM59/19 | IgG3κ | 8.1 | 4+ | NT | 3+ | 3+ | 3+ | 0 to 2+ | 4+ | 3+ | 3+ | 4+ | 0 |
| LHM169/80 | IgG3λ | 6.3 | 4+ | NT | 4+ | 4+ | 4+ | 3+ to 4+ | 4+ | 4+ | 4+ | 4+ | 0 |
| LHM57/17 | IgG1λ | 6.3 | 0 | NT | 0 | 0 | 0 | 0 to 2+ | NT | 0 | 0 | 1+ | 0 |
| LDM1 | IgM | 6.5 | 3+ | NT | 0 | 4+ | 3+ | 0 to 2+ | 4+ | 0 | 2+ | 4+ | 0 |
Immediate spin testing
| Samples | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| Study sample |
Control samples |
||||||||
| Weak D type |
|||||||||
| Test method* | Patient CDe/cDe | 4.0† cDe/cde | 4.1 cDe/cde | 4.2.2‡ cDe/cde | 45 CDe/cde | 64 cDe/cde | 88 cDE/cde | D+ cDe/cde | D– cde/cde |
| Tube | 0 | 2+ | 1+ | 0 | 2+ | 0 | 0 | 3+ | 0 |
| Gel matrix | 3+ | 3+ | 3+ | 1+ to 3+ | 4+ | 3+ | 3+ | 4+ | 0 |