title: Serologic findings of RhD alleles in Egyptians and their clinical implications.
abstract: BACKGROUND
  Serologic discrepancies caused by various reactivity of D variants can only be resolved by the use of RhD genotyping. However, this strategy cannot be applied routinely due to the cost and feasibility. It has been documented that D variants are demonstrated among individuals with positivity for at least C or E antigens. It is considered to be affordable for some countries to test D negative donors who are C or E positive for D variants. It was proposed that an algorithm could be found based on distinct serologic features that matches the Egyptian genetic frequency data, and correctly assigns donors and patients, using the least possible expenses.
  
  
  METHODS
  Samples with the most prevalent weak D and partial D were investigated for their RhCE phenotype. Routine D typing by immediate spin (IS) tube method was performed in parallel with an automated gel test, and the reactivity results of D variants with both techniques were compared.
  
  
  RESULTS
  Among 31 D variants, only 5 were C or E positive (16.1 %). R0r phenotype was associated with the remaining 26 samples (83.9%) and constituted weak D types 4.2 (38.5%), and 4.0/4.1 (11.5%), partial DIII (34.6%), and partial DV (15.4%). Gel reacted strongly with partial DIII and DV. Ten samples with DIII and DV typed as D positive with IS. All weak D were positive by indirect antiglobulin test (IAT), while all partial D were positive by gel and IAT.
  
  
  CONCLUSIONS
  Guidelines for RhD workup should be adjusted to match population data. Detection of D variants among C or E positive donors may not be an optimal strategy for Egyptians. Serology cannot discriminate weak D from partial D, but may provide a clue about the probable D variant to be tested molecularly with the appropriate kit. Reagent selection is important to correctly assign donors and patients with the DIII and DV types.
authors.affiliation: Cairo University Blood Bank, Clinical Pathology Department, Cairo University, Cairo, Egypt. Electronic address: eimanhussein@ymail.com.
authors.forename: Eiman
authors.initials: E
authors.lastname: Hussein
authors.affiliation: Pathology & Immunology, Pediatrics, and Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA.
authors.forename: Jun
authors.initials: J
authors.lastname: Teruya
mesh_terms: D000483:Alleles; D001788:Blood Grouping and Crossmatching; D004534:Egypt; D005260:Female; D005787:Gene Frequency; D006801:Humans; D008297:Male; D012204:Rh-Hr Blood-Group System / Q000097:blood / Q000235:genetics*
chemical_list: D012204:Rh-Hr Blood-Group System; C026410:Rho(D) antigen
keywords: Egyptians; RhD alleles; Serology