Anti-D auto-immunization in a patient with weak D type 4.0
| Autor: | H. Romdhane, B. Houissa, S. Abdelkefi, S. Jemni Yacoub, Mouna Ouchari, T. Chakroun |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Adult
Male Blood transfusion business.industry medicine.medical_treatment Rho(D) Immune Globulin Biochemistry (medical) Clinical Biochemistry Hematology Rh Isoimmunization Molecular analysis Isoantibodies Immunization Immunology Multiplex polymerase chain reaction medicine Humans Blood Transfusion Immunohematological business Antibody screening |
| Zdroj: | Transfusion clinique et biologique : journal de la Societe francaise de transfusion sanguine. 21(1) |
| ISSN: | 1953-8022 |
| Popis: | We report the case of a 56-year-old patient with blood group O+C-c+E-e+K-, followed for a myelodysplasic syndrome and treated by regular pheno-identical and compatible (RBCs) transfusion since December 2007. In June 2009, a positive crossmatch was found with 2 RBCs O+C-c+E-e+K-. A positive anti-body screening with a positive autocontrol was detected and anti-D was unidentified in the patient's serum. The DAT was positive (IgG) and elution identified an anti-D. The following assumptions were then made: it could be a partial D phenotype with anti-D alloantibodies or RH: 1 phenotype with an anti-D auto-antibodies. Molecular analysis by multiplex PCR and sequencing have depisted a weak D type 4.0 phenotype. In October 2009, over three months of RH:-1 RBC transfusion, the antibody screening and DAT (IgG) remained positive, and an eluate made from the patient's erythrocytes contained an anti-D. All these funding confirmed the autoimmune nature of the anti-D. This case report illustrates the importance of a well-conducted and immunohematological laboratories test in order to distinguish between auto- or allo-immune of anti-D in a RH: 1 poly-transfused patients. This distinction is of great importance for transfusion support. |
| Databáze: | OpenAIRE |
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