Ann Lab Med.  2012 Nov;32(6):429-432.

Sensitization to Multiple Rh Antigens by Transfusion of Random Donor Platelet Concentrates in a -D- Phenotype Patient

• Yun JW
• Kang ES
• Ki CS
• Koh KC
• Kim DW

Abstract

The -D- phenotype is a rare Rh phenotype that strongly expresses D antigen without C, c, E, or e antigens. In -D- phenotype individuals, anti-Rh17 (Hro) is commonly found if there is a history of pregnancy or transfusion with red blood cells (RBCs) that express C, c, E, or e antigens. We report the first case of a -D- phenotype patient with multiple Rh antibodies including anti-Rh17 who had a history of two occasions of transfusion with eight random donor platelet concentrates two and six years ago. We found that a trivial amount of RBCs in the platelet components was able to trigger sensitization to RBC antigens, especially the highly immunogenic and clinically significant Rh antigens, including C, c, E, e or CcEe polypeptides. To avoid unnecessary sensitization and to minimize the risk of hemolytic transfusion reactions in patients with this rare Rh phenotype, a modified strategy for pretransfusion screenings needs to be discussed in the field of transfusion medicine.

Keyword

Rh-Hr blood group system; Rh isoimmunization; Platelet transfusion

MeSH Terms

Esophageal Diseases/surgery
Female
Gastrointestinal Hemorrhage
Genotype
Humans
Isoantibodies/blood
Male
Middle Aged
Phenotype
*Platelet Transfusion
Rh-Hr Blood-Group System/genetics/*immunology
Isoantibodies
Rh-Hr Blood-Group System

Figure

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  Fig. 1 AS-PCR result of RHCE/RHD gene of each family member. Abbreviations: MW, molecular weight; AS-PCR, allele-specific polymerase chain reactions.

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