title: Molecular determination of RhD phenotype by DNA typing: clinical applications.
abstract: Rhesus D (RhD) typing is performed by agglutination methods; however, in clinical situations where these techniques cannot be performed, RhD DNA typing is an alternative approach. The Rh antigens are encoded by the RHD and RHCE genes. In RhD-negative individuals the RHD gene is absent or grossly deleted, but variations in the arrangement of the RH locus in different populations are emerging. The aim of this study was to analyse the gross organization of the RH genes in our population using a previously described multiplex polymerase chain reaction (PCR) method with some modifications. We studied 253 DNA samples from Argentinian blood donors, 15 samples with a reduced expression of the D antigen and 1 Dc- phenotype. We evaluated the clinical utility of this method to ascertain the RhD antigen in 10 patients with warm-type autoimmune haemolytic anaemia (AIHA) and 14 samples of amniotic fluids. All Rh phenotypes were properly characterized and no discrepancies with serological typing were found. Analyses performed in the Dc- phenotype suggest the presence of a hybrid RHCE-RHD gene. DNA typing confirmed the RhD-negative type of one AIHA sample in which serological tests were inconclusive. Foetal DNA typing correctly indicated the RhD in every foetus. VNTR (variable number of tandem repeats) and STR (short tandem repeats) analysis detected maternal contamination in two amniocentesis samples and confirmed the foetal origin of 12. This multiplex PCR strategy is suitable for RhD determination in clinical situations in which serological typing cannot be accomplished with its usual ease.
authors.affiliation: Laboratorio de Inmunohematología Histocompatibilidad e Inmunogenética, Departamento de Bioquímica Clínica, Facultad de Ciencias Bioquímicas y Farmacéuticas, Universidad Nacional de Rosario, Suipacha, Argentina. ccotorru@agatha.unr.edu.ar
authors.forename: C
authors.initials: C
authors.lastname: Cotorruelo
authors.forename: C
authors.initials: C
authors.lastname: Biondi
authors.forename: S G
authors.initials: SG
authors.lastname: Borrás
authors.forename: S
authors.initials: S
authors.lastname: Galizzi
authors.forename: R
authors.initials: R
authors.lastname: Di Mónaco
authors.forename: A
authors.initials: A
authors.lastname: Racca
mesh_terms: D000483:Alleles; D000653:Amniotic Fluid / Q000737:chemistry / Q000502:physiology; D000744:Anemia, Hemolytic, Autoimmune / Q000097:blood*; D003298:Coombs Test; D004247:DNA / Q000032:analysis*; D017931:DNA Primers / Q000737:chemistry; D006023:Glycoproteins / Q000235:genetics; D006801:Humans; D018598:Minisatellite Repeats / Q000235:genetics; D010641:Phenotype; D016133:Polymerase Chain Reaction; D015183:Restriction Mapping; D012204:Rh-Hr Blood-Group System / Q000235:genetics*; D012698:Serologic Tests; D020080:Tandem Repeat Sequences / Q000235:genetics
chemical_list: D017931:DNA Primers; D006023:Glycoproteins; C066468:RHCE protein, human; D012204:Rh-Hr Blood-Group System; D004247:DNA