Molecular analysis of patients with weak D and serologic analysis of those with anti-D (excluding type 1 and type 2)

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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 29 , ISSUE 2 (June 2013) > List of articles

Molecular analysis of patients with weak D and serologic analysis of those with anti-D (excluding type 1 and type 2)

Bach-Nga Pham / Michèle Roussel / Dominique Gien / Maryline Ripaux / Carine Auxerre / Pierre-Yves Le Pennec / Christine Andre-Botte

Keywords : anti-D, weak D, partial D, D variant, RHD molecular analysis

Citation Information : Immunohematology. Volume 29, Issue 2, Pages 55-62, DOI: https://doi.org/10.21307/immunohematology-2019-125

License : (Transfer of Copyright)

Published Online: 01-December-2019

ARTICLE

ABSTRACT

Whether or not patients whose red blood cells (RBCs) carry certain weak D types  produce anti-D, and if they do whether it is  allo- or autoanti-D, remains controversial. The aim of this study was to determine the serologic features of anti-D in individuals expressing a weak D other than type 1 or type 2 and to assess whether the anti-D was an allo- or autoantibody. Serologic D typing and molecular analyses were performed on 748 individuals. Serologic characterization of anti-D included autologous controls, direct antiglobulin test, elution, and titration of anti-D before and after adsorption of serum onto autologous RBCs. From molecular analyses, 459 individuals exhibited a weak D type. We described seven novel RHD variant alleles. The most frequent types of weak D were type 1 (30.1%), type 2 (23.7%), type 4.0 (10.2%), type 4.2.2 (20.3%), type 11 (3.9%), and type 15 (3.7%). Anti-D was identified in the sera of 9 of 47 individuals with weak D type 4.0, in 14 of 93 with weak D type 4.2.2, in 1 of 18 with weak D type 11, in 1 of 17 with weak D type 15, and in 1 weak D type 33 individual. Anti-D was demonstrated to be an alloantibody in weak D type 4.0, type 4.2.2, and type 15 individuals, but an autoantibody in weak D type 11 and type 33 individuals. In conclusion, only a complete serologic investigation of individuals with a given weak D type identified by molecular analysis allows concluding on the nature of the antibody. Transfusing weak D type 4.2.2 and type 15 patients with D– RBC units and proposing anti-D immunoprophylaxis to women with these weak D types should be considered.

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