Korean J Blood Transfus.  2022 Apr;33(1):32-38. 10.17945/kjbt.2022.33.1.3 2.

Case Report of Anti-f(ce) Antibody Identified Simultaneously with Anti-M Antibody in a Patient with Liver Cirrhosis

• Youk HJ
• Kim JS
• Hwang SH
• Oh HB
• Ko DH

• KMID: 2529876
• DOI: http://doi.org/10.17945/kjbt.2022.33.1.3 2

Abstract

The Rh blood group system has C, D, E, c, and e as the main antigens, but ce(f) has been reported as a compound antigen. Anti-f(ce) is an unexpected antibody (Ab) against the ce(f) compound antigen. This paper reports a case with anti-f(ce) and anti-M Abs in a patient with liver cirrhosis. A 47-year-old male patient was repeatedly admitted to hospital due to recurrent hepatic encephalopathy. He showed disorientation and was admitted. A packed red blood cells (pRBCs) transfusion was required, and Ab identification test identified anti-f(ce) and anti-M Abs. Anti-f(ce) Ab can cause fetal neonatal hemolytic disease and a clinically serious hemolytic transfusion reaction (HTR), and anti-M Ab can cause a HTR when it reacts at 37℃. RBCs with Rh haplotype of CDe and negative for M antigen were transfused to the patient. There was no HTR. The possibility of an anti-f(ce) Ab was not considered when an unexpected Ab screening/identification test was performed. It was simply reported as an ‘unknown alloantibody’. Therefore, laboratory physicians should consider Abs to the Rh compound antigen when Abs to Rh antigens are identified, and efforts should be made to identify them to gain basic knowledge about Abs against Rh compound antigens.

Keyword

Anti-f(ce) antibody; Anti-M antibody; Rh compound antigens; Unexpected antibody identification