title: Alloimmunization to the D antigen by a patient with weak D type 21.
abstract: Antibodies of apparent D specificity may be found in D+ patients. We report a D+, multi-transfused Caucasian woman with myelodysplasia who exhibited several alloantibodies. One antibody was a moderately strong (2+) anti-D that persisted for 9 months, until the woman died. Molecular analysis of the patient's RHD gene identified the rare weak D type 21 (938C > T) allele. D alloantibodies do not occur in patients with most weak D types, but some patients with a weak D phenotype, including those with type 21, can produce antibodies to nonself epitopes of the wild-type D antigen.
authors.affiliation: Department of Pathology, Sinai Hospital, Baltimore, MD 21215, USA.
authors.forename: H
authors.initials: H
authors.lastname: McGann
authors.forename: R E
authors.initials: RE
authors.lastname: Wenk
mesh_terms: D000368:Aged; D000483:Alleles; D016913:Blood Component Transfusion / Q000009:adverse effects*; D001787:Blood Group Incompatibility / Q000276:immunology*; D000939:Epitopes / Q000276:immunology; D017809:Fatal Outcome; D005260:Female; D005838:Genotype; D006801:Humans; D007518:Isoantibodies / Q000097:blood / Q000276:immunology*; D009190:Myelodysplastic Syndromes / Q000097:blood* / Q000276:immunology / Q000628:therapy; D010198:Pancytopenia / Q000097:blood* / Q000276:immunology / Q000628:therapy; D017354:Point Mutation; D012204:Rh-Hr Blood-Group System / Q000276:immunology*; D018029:Rho(D) Immune Globulin
chemical_list: D000939:Epitopes; D007518:Isoantibodies; C061961:RHO(D) antibody; D012204:Rh-Hr Blood-Group System; D018029:Rho(D) Immune Globulin; C026410:Rho(D) antigen