Korean J Lab Med.  2009 Aug;29(4):361-365. 10.3343/kjlm.2009.29.4.361.

Primary anti-D Immunization by DEL Red Blood Cells

• Kim KH
• Kim KE
• Woo KS
• Han JY
• Kim JM
• Park KU

• KMID: 1096931
• DOI: http://doi.org/10.3343/kjlm.2009.29.4.361

Abstract

Extremely weak D variants called DEL are serologically detectable only by adsorption-elution techniques. A nucleotide change of exon 9 in RHD gene, RHD (K409K, 1227G>A) allelic variant is present in almost all the DEL individuals of East Asians. No DEL phenotype has yet been shown to induce a primary alloanti-D immunization in East Asia. A 68-yr-old D-negative Korean man was negative for anti-D at admission, and he developed alloanti-D after transfusion of red blood cells (RBC) from 4 apparently D-negative donors. Four donors who typed D-negative by routine serologic test were analyzed by real-time PCR for RHD gene and RHD (K409K). One donor was found to have RHD (K409K). This is the first case in which DEL RBCs with RHD (K409K) induced a primary alloanti-D immunization in Asian population. Because the DEL phenotype can induce an anti-D immunization in D-negative recipients, further discussion is needed whether RhD negative donors should be screened by molecular method and what an efficient genotyping method is for detecting the RHD gene carriers in Korea.

Keyword

RHD; DEL RBC; Anti-D antibody; Alloimmunization

MeSH Terms

Aged
Blood Donors
Blood Grouping and Crossmatching
Blood Transfusion/*adverse effects
Exons
Humans
Isoantibodies/*metabolism
Male
Phenotype
Polymerase Chain Reaction
Rh-Hr Blood-Group System/genetics/*immunology

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