title: Sensitization to multiple rh antigens by transfusion of random donor platelet concentrates in a -D- phenotype patient.
abstract: The -D- phenotype is a rare Rh phenotype that strongly expresses D antigen without C, c, E, or e antigens. In -D- phenotype individuals, anti-Rh17 (Hr(o)) is commonly found if there is a history of pregnancy or transfusion with red blood cells (RBCs) that express C, c, E, or e antigens. We report the first case of a -D- phenotype patient with multiple Rh antibodies including anti-Rh17 who had a history of two occasions of transfusion with eight random donor platelet concentrates two and six years ago. We found that a trivial amount of RBCs in the platelet components was able to trigger sensitization to RBC antigens, especially the highly immunogenic and clinically significant Rh antigens, including C, c, E, e or CcEe polypeptides. To avoid unnecessary sensitization and to minimize the risk of hemolytic transfusion reactions in patients with this rare Rh phenotype, a modified strategy for pretransfusion screenings needs to be discussed in the field of transfusion medicine.
authors.affiliation: Department of Laboratory Medicine & Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Jae Won
authors.initials: JW
authors.lastname: Yun
authors.forename: Eun-Suk
authors.initials: ES
authors.lastname: Kang
authors.forename: Chang-Seok
authors.initials: CS
authors.lastname: Ki
authors.forename: Kwang Cheol
authors.initials: KC
authors.lastname: Koh
authors.forename: Dae Won
authors.initials: DW
authors.lastname: Kim
mesh_terms: D004935:Esophageal Diseases / Q000601:surgery; D005260:Female; D006471:Gastrointestinal Hemorrhage; D005838:Genotype; D006801:Humans; D007518:Isoantibodies / Q000097:blood; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D017713:Platelet Transfusion; D012204:Rh-Hr Blood-Group System / Q000235:genetics / Q000276:immunology*
chemical_list: D007518:Isoantibodies; C033242:RH-antibodies; C066468:RHCE protein, human; D012204:Rh-Hr Blood-Group System; C026410:Rho(D) antigen
keywords: Platelet transfusion; Rh isoimmunization; Rh-Hr blood group system