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Citation Information : Immunohematology. Volume 28, Issue 3, Pages 97-103, DOI: https://doi.org/10.21307/immunohematology-2019-158
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Published Online: 01-December-2019
Anti-hrB (-RH31) and anti-HrB (-RH34) were found nearly 40 years ago in the serum of a South African woman. The anti-hrB was revealed after adsorption with DcE/DcE red blood cells (RBCs). Numerous anti-hrB, in the absence of anti-HrB, have since been identified. We obtained a sample of blood from this index case (Bastiaan) and report the molecular basis of her D+C–E–c+e+/–, V–VS+Hr+hrS+hrB–HrB– phenotype as well as results of testing her RBCs using currently available reagents. We tested a cohort of African Americans to estimate the frequency of the RHCE*ce 48C, 733G, 1006T allele, and in addition found two novel RHD alleles. Hemagglutination tests and DNA analyses were performed by standard methods. Analyses revealed homozygosity for RHCE*ce 48C, 733G, 1006T in Bastiaan. RBCs from Bastiaan were strongly agglutinated by three commercial anti-e reagents. Testing RBCs from people homozygous for RHCE*ce 48C, 733G, 1006T showed that anti-e MS16, MS17, and MS63 were weakly reactive or nonreactive, MS21 was strongly reactive, and HIRO38, HIRO41, and HIRO43 were nonreactive. Results show that Bastiaan has RHD*DIIIa150C and RHD*DIIIa-CE(4-7)-D. Tests on 605 samples from random African Americans revealed a frequency of 0.036 for RHCE*ce 48C, 733G, 1006T and revealed two novel alleles: RHD*186T and RHD*DIIIa 150C. The Bastiaan phenotype is encoded by RHD*DIIIa150C-RHCE*ce 48C, 733G, 1006T and RHD*DIIIa-CE(4-7)-D-RHCE*ce 48C, 733G, 1006T; thus, this genotype is the gold standard for the hrB–HrB– phenotype. The r′S complex encodes VS, which explains why most hrB– RBCs are VS+.