A Case of A1B3 Child from a Group A Mother and a Group B Father: New Group B Allele Arising from 547G>A / 대한수혈학회지

Group B subtype, A1B3, was observed in a 22-year-old blood donors by conventional serologic test. In our family study, his father demonstrated uncomplicated B phenotype and his mother typed as group A. We sequenced exon 6 and 7 of phenotypically A1B3 propositus and his family members by direct sequencing and PCR-based cloning. And we have identified a novel Bvar allele characterized by a 547G>A polymorphism present in propositus and his father. This suggests that the Bvar allele is expressed differently depending on the co-inherited ABO allele.

Reactivity Patterns of Various Anti-D Reagents in 14 Cases with Partial D / 대한진단검사의학회지

BACKGROUND: A weak D type resulted from a quantitative reduction of the RhD antigen, whereas a partial D type resulted from a qualitatively altered RhD protein. Based on different serological properties from a weak D type, a partial D type was suspected in cases with anti-D in their serum or if nonreactive to some reagents. Most Red Cross Blood Centers pay attention to donors in determining RhD typing with a monoclonal anti-D reagent. This study examined the reactivity patterns of 4 different monoclonal anti-D reagents in RhD typing and a weak D test in 14 cases with partial D. MATERIALS AND METHODS: We collected a total of 201, 847 samples from blood donors and screened out 649 samples as Rh-negative in RhD typing with monoclonal anti-D (Bioscot) and bromelin treatment applied to an automatic analyzer between October 2002 and March 2003. Further, we performed RhD typing and weak D test using the tube method with 4 commercially available monoclonal anti-D reagents. In 14 cases with different reactivity patterns, we performed a confirming test for partial D using a `ID-partial RhD-typing' (Diamed, Switzerland) set consisting of 6 monoclonal antibodies. RESULTS: Partial D(DFR) was observed in 92.9% (13/14) and a partial D(indeterminate) was observed in 7.1% (1/14). The red blood cells from 14 cases with partial D were not agglutinated with 4 various commercially available anti-D reagents. However, in subsequently performed weak-D tests, different reactivity to their anti-D reagents were shown, namely irresponsiveness (Dade Behring, 14/14, 100%), trace-to-1+ responsiveness (Ortho-clinical diagnostics, 13/14, 92.9%), trace-to-3+ responsiveness (Bioscot, 14/14, 100%), and 1+-to-3+ responsiveness (GreenCross, Korea, 14/14, 100%). CONCLUSIONS: Considering that the most partial D discovered in the Southwestern area of Korea was partial D(DFR), it is recommended that RhD typing and/or weak D tests in blood donors should be done using more than two anti-D reagents from different clones.

Two cases of partial-D showing different reactivity to various anti-D reagents / 대한수혈학회지

The 19-year-old twin sisters donated their blood in 2000. Their blood had typical Rh D negative red cell phenotype in Rh typing and weak D test using an anti-D reagent (Dade Behring, USA). Twin sisters donated blood again in 2001. Both were negative in anti-D reagent (Bioscotte Ltd., UK) and weakly positive in additively performed weak-D test. So we have acquired blood samples from them for further study in 2002. The red blood cells from twin sisters were not agglutinated with 4 various commercially available anti-D reagents. But in subsequently performed weak-D test, different reactivity to their anti-D reagents were shown, namely negative (Dade Behring, USA) and weakly positive (Ortho-clinical diagnostics, USA; Greencross, Korea; Bioscotte Ltd., UK). The lack of reactivity with some anti-D as shown in these cases can indicate the presence of a partial D antigen. So we carried out a additional serologic test using 6 monoclonal anti-D antibodies in partial-D typing set (Diamed, Switzerland) on Rh D antigens of red cells from twin sisters. According to the different reactivity patterns, we confirmed elder sister was partial-D category DFR and younger sister was partial-D with indeterminate category.