[Molecular blood genotyping in patients with Thalassemia major in Tehran adult thalassemic clinic]

Blood typing by serologic methods after transfusion has limitations due to presence of donor red cells in recipients. Accurate determination of red blood cells [RBCs] antigens is very important in multitransfused patients including beta-thalassemics and sickle cell anemics. So, the aim of this study was to evaluate DNA- based methods as supplement to the hemagglutination technique to determine the red blood cell [RBC] antigen profile of multitransfused patients with beta- thalassemia. DNA was extracted from peripheral blood of 20 apparently normal people and 44 patients including 35 with beta- thalassemia [out of whom 19 had clinical evidence of delayed hemolytic transfusion reaction], 8 with thalassemia intermedia [out of whom 2 had hemolytic reaction], and one with sickle cell thalassemia. RHD/ RHC/ RHc/ RHE/ RHe/ JKA/ JKB/ FYA/ FYB/ KELL1/ KELL2 alleles were determined by PCR and were then compared with the hemagglutination method. Phenotype and genotype results were the same in all controls. The phenotypes and genotypes of 53 blood antigens of 26 patients were incompatible. Most of the discrepancies [19 cases] occurred in the Rh system, and fifteen in the Duffy and Kidd systems. The results show that screening platelet concentrates for bacterial contamination is necessary for blood transfusion centers and hospital blood banks. Blood typing by serologic method was not accurate in this study but genotyping could determine true blood groups in multitransfused patients and help in selection of RBCs without alloimmunized antigens in future transfusion attempts. Specificity, sensitivity, positive and negative predictive values of hemagglutination method for RhD antigen had good values in comparison to the molecular method. This might be due to pre- transfusion determination of RhD for thalassemic patients so as to receive Rh- matched blood units. It seems pre-transfusion blood typing of Rh and Kell antigens, which are the cause of hemolytic reactions, in comparison to the molecular method could be cost effective. In addition, typing of Rh and Kell antigens in some regular blood donors could be helpdul for selecting antigen-negative RBCs for transfusion dependent patients

Detection of hepatitis B virus DNA [PCR] in HBsAg negative, anti-HBc positive blood donors in Tehran province

The incidence of post transfusion hepatitis has been reduced by blood donor screening for HBsAg, but the HBV infection is still responsible for certain cases of post-transfusion hepatitis world-wide. An estimate of the rate of HBV DNA and anti-HBc positive units is important for evaluation of the need for anti-HBc blood donor screening. In this study, the HBsAg negative blood units were evaluated for anti-HBc and all of anti-HBc positive units were tested for HBV DNA by PCR method. Extra samples were collected from 2000 HBsAg, anti-HCV, anti-HIV and RPR-negative blood donors. All of the samples were examined by the approved anti-HBc assay. All anti-HBc positive samples were tested by anti-HBs assays and evaluated for HBV DNA [PCR]. The sensitivity of the HBV DNA [PCR] assasy was estimated to be 300 geq/ml according to VQC proficiency panels. 230 [11.5%] out of 2000 samples were positive for anti-HBc. 179 [77.8%] out of 230 anti-HBc positive samples were HBsAb positive, and 51 [23.2%] HBsAb negative. All 230 samples were assayed for single HBV DNA [PCR] 227 of which came out to be negative for HBV DNA [PCR]. Three blood donors were recalled and new samples from two of whom were collected. These new samples were negative for HBV DNA. Further study for evaluation of HBV DNA in anti-HBc positive blood units with full automatic instruments and usage of blood bags with accessories is strongly recommended

case report of thrombophilia emanated from G20210A prothrombin mutation

G20210A prothrombin mutation is one of the most prevalent mutations in the western countreis. In most diagnostic algorithms, G20210A prothrombin mutation's identification is the major tool in determining the cause of thrombosis. However, there is little evidence about the prevalence of this mutation in thrombophilia and its role among Asian and especially Iranian people. According to sporadic investigations there exist some evidence of the low prevalence rate of the mutation in Iranian patients. The case at issue has been negative in regard to other inherited and acquired causes; thus, the researchers intended to study the mutation rate in this case. The patient under study had the past record of recurrent miscarriage and CVA. Considering the limited number of studies conducted on thrombosis genetic prevalence and their impact on recurrent abortions and thrombophilia in Iran, this study is considered to be the first report on the screening of G20210A mutation. In this regard, the role of this mutation in unexplained miscarriage and exacerebation of underlying disorders could be investigated