Korean J Lab Med.  2007 Oct;27(5):369-372. 10.3343/kjlm.2007.27.5.369.

A RhD Negative Patient Failed to Produce Detectable Anti-D after Transfusion of 35 Units of RhD Positive Red Blood Cells

• Lee WM
• Kim JH
• Ha JS
• Ryoo NH
• Jeon DS
• Kim JR
• Cho D

• KMID: 1781537
• DOI: http://doi.org/10.3343/kjlm.2007.27.5.369

Abstract

In the present day, pretransfusion tests include ABO and RhD grouping, antibody screening, antibody identification, and cross matching. Although error rates for these tests have decreased compared to those in the past, clerical errors still occur. When exposed to RhD positive RBCs, a RhD negative person can produce anti-D that causes a severe hemolytic disease of the fetus and the newborn in addition to hemolytic transfusion reactions. Therefore, administration of RhD positive RBCs to a RhD negative person should be avoided. We experienced a RhD negative patient who had been misidentified as positive and transfused 35 units of RhD positive RBCs eight years ago, but did not have detectable anti-D in present. The red cells of the patient showed no agglutination with the anti-D reagent and a negative result in the standard weak D test. The multiplex PCR with sequence-specific priming revealed that the patient was RhD negative.

Keyword

RhD negative; Anti-D and PCR; SSP

MeSH Terms

*Blood Group Incompatibility
Blood Transfusion
Erythrocytes/*immunology
Humans
Isoantibodies/*analysis/immunology
Male
Middle Aged
Polymerase Chain Reaction
Rh-Hr Blood-Group System/*analysis/immunology

Figure

• 

  Fig. 1. PCR sequence specific primers pattern of RHD alleles. RhD positive sample (1, 2) shows the amplified fragments of intron 4 (224 bp) and exon 7 (123 bp) of RhD gene. RhD negative sample (3, 4) and this patient (5, 6) show the lack of amplified fragments. In all lanes, a 443 bp fragment (human growth hormone), representing internal control, was amplified. M: DNA molecular weight marker with 100 bp increment.

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