Blocked D phenomenon and relevance of maternal  serologic testing

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Immunohematology

American National Red Cross

Subject: Medical Laboratory Technology

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ISSN: 0894-203X
eISSN: 1930-3955

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VOLUME 31 , ISSUE 3 (September 2015) > List of articles

Blocked D phenomenon and relevance of maternal  serologic testing

Ashish Jain * / Vijay Kumawat / Neelam Marwaha

Keywords : blocked D phenomenon, maternal serologic testing, antibody screening  

Citation Information : Immunohematology. Volume 31, Issue 3, Pages 116-118, DOI: https://doi.org/10.21307/immunohematology-2019-078

License : (Transfer of Copyright)

Published Online: 26-October-2019

ARTICLE

ABSTRACT

A blood requisition for double-volume exchange transfusion was received for a 2-day-old male child born to a 29-yearold multiparous female (P2002) referred to our institute having neonatal jaundice with encephalopathy; no maternal sample was received. The neonatal blood sample was typed as group A, D–, and the direct antiglobulin test (DAT) was strongly positive (4+) using the gel method. Mono-specific DAT showed the presence of IgG antibodies on neonatal red blood cells (RBCs). Acid elution and gentle heat elution (at 56°C) confirmed the presence of anti-D on neonatal RBCs. The baby received two exchange transfusions with group O, D–, packed RBCs compatible with his own serum. Later, on day 3, the neonate’s mother was typed as group AB, D–, and her serum revealed the presence of alloanti-D, -C, and -S reactive in the anti-human globulin phase. The anti-D titer was 1024. This report highlights the “blocking” phenomenon caused by maternal anti-D in a case of hemolytic disease of fetus and newborn with a positive DAT.

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