Primary anti-D immunization by DEL red blood cells.
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.
Kim
Kyeong-Hee
KH
Department of Laboratory Medicine, Dong-A University College of Medicine, Busan, Korea. progreen@dau.ac.kr
Kim
Kyung-Eun
KE
Woo
Kwang-Sook
KS
Han
Jin-Yeong
JY
Kim
Jeong-Man
JM
Park
Kyoung Un
KU
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
D007518:Isoantibodies; C061961:RHO(D) antibody; D012204:Rh-Hr Blood-Group System; D018029:Rho(D) Immune Globulin