title: Primary anti-D immunization by DEL red blood cells.
abstract: Extremely weak D variants called DEL are serologically detectable only by adsorption-elution techniques. A nucleotide change of exon 9 in RHD gene, RHD (K409K, 1227G>A) allelic variant is present in almost all the DEL individuals of East Asians. No DEL phenotype has yet been shown to induce a primary alloanti-D immunization in East Asia. A 68-yr-old D-negative Korean man was negative for anti-D at admission, and he developed alloanti-D after transfusion of red blood cells (RBC) from 4 apparently D-negative donors. Four donors who typed D-negative by routine serologic test were analyzed by real-time PCR for RHD gene and RHD (K409K). One donor was found to have RHD (K409K). This is the first case in which DEL RBCs with RHD (K409K) induced a primary alloanti-D immunization in Asian population. Because the DEL phenotype can induce an anti-D immunization in D-negative recipients, further discussion is needed whether RhD negative donors should be screened by molecular method and what an efficient genotyping method is for detecting the RHD gene carriers in Korea.
authors.affiliation: Department of Laboratory Medicine, Dong-A University College of Medicine, Busan, Korea. progreen@dau.ac.kr
authors.forename: Kyeong-Hee
authors.initials: KH
authors.lastname: Kim
authors.forename: Kyung-Eun
authors.initials: KE
authors.lastname: Kim
authors.forename: Kwang-Sook
authors.initials: KS
authors.lastname: Woo
authors.forename: Jin-Yeong
authors.initials: JY
authors.lastname: Han
authors.forename: Jeong-Man
authors.initials: JM
authors.lastname: Kim
authors.forename: Kyoung Un
authors.initials: KU
authors.lastname: Park
mesh_terms: D000368:Aged; D001782:Blood Donors; D001788:Blood Grouping and Crossmatching; D005091:Exons; D006801:Humans; D007518:Isoantibodies / Q000378:metabolism*; D008297:Male; D010641:Phenotype; D016133:Polymerase Chain Reaction; D012204:Rh-Hr Blood-Group System / Q000235:genetics / Q000276:immunology*; D018029:Rho(D) Immune Globulin; D065227:Transfusion Reaction
chemical_list: D007518:Isoantibodies; C061961:RHO(D) antibody; D012204:Rh-Hr Blood-Group System; D018029:Rho(D) Immune Globulin