Coombs indireto com presença de anti-M IgM em uma gestante com fator Rh positivo ­ relato de caso / Indirect Coombs test with presence of anti-M IgM in a pregnant woman with Rh positive factor ­ case report

A aloimunização é caracterizada pela produção de anticorpos na vigência de ex- posição a antígenos não próprios, estando mais relacionada ao sistema ABO/Rh. Contudo, infrequentemente, a doença pode surgir por meio da exposição por antí- genos de outros sistemas sanguíneos, como o sistema MNSs. O caso deste estudo relata o acompanhamento do pré-natal de uma paciente com tipagem sanguínea O+ e Coombs indireto reagente com variação de titulação ao longo das consultas, sendo evidenciada a presença de anti-M IgM por pesquisa de anticorpos antieri- trocitários irregulares, entretanto sem repercussões fetais. Com isso, no decorrer das análises bibliográficas, notou-se que o Coombs indireto (antiglobulina hu- mana anti-IgG) é capaz de reagir com as imunoglobulinas A e M, sendo, portanto, teoricamente capaz de ser positivado pelo anti-M IgM. Com isso, e devido ao fato de o fator IgM não atravessar a barreira transplacentária, não houve complicações fetais no presente caso clínico.

Alloimmunization is characterized by the production of antibodies in the presence of exposure to non-self antigens, most commonly associated with the ABO/Rh system. However, infrequently, the condition can arise from exposure to antigens from other blood systems, such as the MNSs system. This study reports the prenatal monitoring of a patient with blood type O+ and a reactive indirect Coombs test with titration variations during consultations. The presence of anti-M IgM was evidenced through irregular anti-erythrocyte antibody screening; however, no fetal repercussions were observed. Throughout the bibliographic analyses, it was observed that the indirect Coombs test (human anti-IgG globulin) is capable of reacting with immunoglobulins A and M. Therefore, it is theoretically possible to be positive due to anti-M IgM. Con- sequently, as the IgM factor does not cross the transplacental barrier, there were no fetal complications in the present clinical case.

Establishment of a genotyping method for the junior blood group and identification of a rare blood type with partial DVI.3 and Jr(a-) / 中华医学遗传学杂志

OBJECTIVE@#To develop a genotyping method for the Junior blood type and report on a rare blood type with Jr(a-).@*METHODS@#Healthy O-type RhD+ volunteer donors of the Shenzhen Blood Center from January to May 2021 (n = 1 568) and a pedigree with difficult cross-matching (n = 3) were selected as the study subjects. Serological methods were used for proband's blood type identification, unexpected antibody identification, and antibody titer determination. Polymerase chain reaction-sequence specific primer (PCR-SSP) method was used for typing the proband's RhD gene. ABCG2 gene coding region sequencing and a PCR-SSP genotyping method were established for determining the genotypes of the proband and his family members and screening of Jra antigen-negative rare blood type among the 1 568 blood donors.@*RESULTS@#The proband's ABO and RhD blood types were respectively determined as B and partial D (RHDDVI.3/RHD01N.01), Junior blood type Jra antigen was negative, and plasma had contained anti-D and anti-Jra. Sequencing of the ABCG2 gene revealed that the proband's genotype was ABGG201N.01/ABGG201N.01 [homozygous c.376C>T (p.Gln126X) variants], which is the most common Jr(a-) blood type allele in the Asian population. Screening of the voluntary blood donors has detected no Jr(a-) rare blood type. Statistical analysis of the heterozygotes suggested that the allelic frequency for ABCG2*01N.01 (c.376T) was 0.45%, and the frequency of Jr(a-) rare blood type with this molecular background was about 0.2‰.@*CONCLUSION@#A very rare case of partial DVI.3 type and Jr(a-) rare blood type has been identified. And a method for identifying the Junior blood type through sequencing the coding regions of the ABCG2 gene and PCR-SSP has been established.

Non-RhD alloimmunization in pregnancy: an updated review

Abstract RhD alloimmunization in pregnancy is still the main cause of hemolytic disease of the fetus and neonate (HDFN). Nevertheless, there are other antigens that may be associated with the occurrence of this phenomenon and that have been growing in proportion, given that current prevention strategies focus only on anti-RhD antibodies. Although not widespread, the screening and diagnostic management of the disease caused by these antibodies has recommendations in the literature. For this reason, the following review was carried out with the objective of listing the main red blood cell antigen groups described — such as Rh, ABO, Kell, MNS, Duffy, Kidd, among others — addressing the clinical importance of each one, prevalence in different countries, and recommended management when detecting such antibodies during pregnancy.

Development of blood transfusion external quality assessment program at national scale / Desarrollo de un programa de evaluación externa de calidad de la transfusión sanguínea a nivel nacional

Introduction: External quality assessment is a crucial component in ensuring the quality of blood transfusion testing laboratories. Objectives: To develop a procedure for generating external quality assessment items for blood transfusion testing to evaluate participants' performance. Methods: Experimental research was conducted at Quality Control Center for Medical laboratory- University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam. Three items, including red blood cell, serum, and atypical antibody serum samples, were assessed for homogeneity and stability; 5 assessment areas, including ABO grouping, Rh grouping, compatible cross matches, Coombs test, and screening of atypical antibodies, were utilized to evaluate the performance of 38 participants in the 2020-2021 period. Results: Red blood cell and serum samples maintained quality for a specific period at controlled temperatures, while serum samples with atypical antibodies showed stability at different temperatures. The participants demonstrated high satisfactory performance in ABO grouping, Rh grouping, Coombs test, and screening for atypical antibodies. However, the most unsatisfactory performance was reported in crossmatching, with 15 percent of participants unsatisfactory results. Conclusion: The procedure of production of proficiency testing items has been successfully developed, and its application at the national level is suggested to improve the quality of blood transfusion laboratories(AU)

Introducción: La evaluación externa de calidad es esencial para asegurar la calidad de los laboratorios de pruebas de transfusión sanguínea. Objetivos: Desarrollar un procedimiento para generar elementos de evaluación externa de calidad y evaluar el rendimiento de los participantes en pruebas de transfusión sanguínea. Métodos: Estudio experimental realizado en el Centro de Control de Calidad para Laboratorios Médicos de la Universidad de Medicina y Farmacia en la Ciudad de Ho Chi Minh, Vietnam. Se evaluaron muestras de glóbulos rojos, suero y suero con anticuerpos atípicos para homogeneidad y estabilidad. Se utilizaron 5 áreas de evaluación, incluida la agrupación ABO, la agrupación Rh, las coincidencias cruzadas compatibles, la prueba de Coombs y la detección de anticuerpos atípicos, para evaluar el desempeño de 38 participantes, en el período 2020-2021. Resultados: Las muestras de glóbulos rojos y suero mantuvieron la calidad durante un período específico a temperaturas controladas, mientras que las muestras de suero con anticuerpos atípicos mostraron estabilidad a diferentes temperaturas. Los participantes obtuvieron un alto rendimiento en algunas áreas, como la agrupación ABO y Rh, la prueba de Coombs y la detección de anticuerpos atípicos. Sin embargo, las pruebas de compatibilidad reportaron un rendimiento insatisfactorio en un 15 por cientode los participantes. Conclusión: El procedimiento desarrollado cumple con los criterios de calidad, y se sugiere su aplicación a nivel nacional para mejorar la calidad de los laboratorios de transfusión sanguínea(AU)

Manual de procesos y procedimientos para la gestión de la sangre, inmunohematología y hemoterapia / Manual of processes and procedures for blood management, immunohematology and hemotherapy

El presente manual de procesos y procedimientos documenta los servicios que se ofrecen en la atención al usuario interno y externo para la gestión de la sangre, inmunohematología y hemoterapia como parte del proceso de atención en salud integral e integrada a la persona en el curso de vida con enfoque de atención primaria en salud, describe el sistema de operación ofrecido en los establecimientos de salud, mediante el enfoque por procesos, fomentando así el desarrollo organizacional y el mejoramiento continuo para el cumplimiento de la misión institucional. Establece las bases para la ejecución de los procedimientos como parte de los procesos institucionales, unificando criterios de contenido que permite la sistematización de las actividades y la definición de la metodología para efectuarlas. Esta herramienta táctica y operativa, permite integrar las actividades y tareas de manera oportuna, para el logro de la prestación de servicios con calidad en los establecimientos de salud que lo necesiten, facilitando el cumplimiento de las normativas y lineamientos de programas especiales o por ciclo de vida vigentes en el Ministerio de Salud, así como la armonización con la sistematización y uso de herramientas tecnológicas que sea necesario implementar para volver más eficaz el trabajo del talento humano en salud

This manual of processes and procedures documents the services offered in the care of internal and external users for blood management, immunohematology and hemotherapy as part of the process of comprehensive and integrated health care for the person throughout the life course. With a focus on primary health care, it describes the operation system offered in health establishments, through the process approach, thus promoting organizational development and continuous improvement to fulfill the institutional mission. Establishes the bases for the execution of procedures as part of institutional processes, unifying content criteria that allows the systematization of activities and the definition of the methodology to carry them out. This tactical and operational tool allows the integration of activities and tasks in a timely manner, to achieve the provision of quality services in the health establishments that need it, facilitating compliance with the regulations and guidelines of special programs or by cycle of life in force in the Ministry of Health, as well as harmonization with the systematization and use of technological tools that need to be implemented to make the work of human talent in health more effective

Phenotyping of clinically significant blood group antigens among the South Indian donor population

ABSTRACT Introduction: Data on the prevalence of clinically significant antigens (Rh, Kell, Kidd, Duffy, MNSs, Lewis, P and Lutheran) among the Indian donor population is sparse. Objective: This prospective study was aimed at determining the prevalence of 21 clinically significant antigens for the first time in the South Indian donor population. Method: A total of 672 regular O group blood donors were enrolled for Rh (C, c, E, e) and Kell (K) antigens typing. Of these, 188 donors were typed for other clinically significant antigens (k, Kpa, Kpb, Jka, Jkb, Fya, Fyb, M, N, S, s, P1, Lea, Leb, Lua and Lub). Results: Antigen frequencies were expressed in percentages. In our study, R1R1 and rr were the most common phenotypes among D+ and D− donors, respectively. Among the Rh antigens, the e antigen was expressed by 97.5% and 100% of D+ and D− donors, respectively. The K antigen was found in only 0.15% of donors. In the Duffy and Kidd blood group system, Fy (a+b+) and Jk (a+b+) were the most frequent phenotypes, respectively. In the MNSs blood group system, M+N+ and S−s+ were the most common phenotypes reported. The Le (a−b+) was found to be the phenotype with the highest prevalence in the Lewis blood group system. The Lu (a−b+) was the only phenotype found in the Lutheran blood group system. Conclusion: Knowledge regarding the prevalence of antigens in a given population is essential in developing cost-effective in-house panels and a rare donor registry comprising donors typed negative for a high-frequency antigen or a combination of common multiple antigens.

Molecular Mechanism of a Rhesus D Variant Individual with RHD*845A/1227A / 中国实验血液学杂志

OBJECTIVE@#To explore the genetic mutation mechanism of a rare Rhesus D variant individual.@*METHODS@#Regular serological assay was used for determination of Rh type for the sample. Indirect anti-human globulin test (IAT) was used to confirm the RhD antigen and screen the antibodies. D-screen reagent was used to analyze the RhD epitopes of the sample. RHD genotype and RHD zygosity testing of the sample were detected by palymerase chain reaction with sequence-specific primers (PCR-SSP). The full length coding region of RHD gene was sequenced. RHD mRNA was detected using reverse transcription polymerase chain reaction (RT-PCR). The PCR products were cloned and sequenced.@*RESULTS@#The RhD blood group of the sample was determined as weak D, and the Rh phenotype was CcDEe. The antibody screening was negative. The sample tested with all monoclonal anti-Ds in D-screen showed the D epitope profiles as partial D types. The analysis of RHD gene sequence indicated that the individual with RHD c.845G/A and RHD c.1227G/A base heterozygosis. Three kinds of alternative splicing isoforms were obtained by TA cloning and sequencing.@*CONCLUSION@#The object has RHD c.845G/A and RHD c.1227G/A mutation. This heterozygous mutation is responsible for the low expression of RhD antigen on the red blood cells of the sample.

Serology and genomic analysis of para-Bombay individuals in a hospital in Hunan Province / 中华预防医学杂志

To investigate the serological and genetic characteristics of para-Bombay patients in a hospital in Hunan Province. A retrospective analysis was conducted on the blood type results of 175 439 hospitalized patients born in Hunan Province from the Third Xiangya Hospital, Central South University from 2016 to 2021. Phenotypes of ABO blood group was analyzed by blood group serology, and molecular biological methods were used to analyze the genotype, including ABO genotyping by polymerase chain reaction-sequence specific primers (PCR-SSP) and fucosyltransferase 1 (FUT1) and fucosyltransferase 2 (FUT2) gene sequencing. The results showed that 3 cases of Ah and 1 case of Bh were detected. FUT1 sequencing showed that there were 2 cases of h3h3, 1 case of h1h1 and 1 case of h302h1, of which h302 (c.302C>T) was the first discovered mutation. FUT2 sequencing revealed that 4 cases were all Se357Se357. The pedigree study showed that the inheritance of para-Bombay blood group was consistent with autosomal dominant inheritance. In conclusion, the FUT1 gene mutations leading to para-Bombay blood group mainly include h3, h1 and h302, of which h3 mutation is the most common.

Serology and genomic analysis of para-Bombay individuals in a hospital in Hunan Province / 中华预防医学杂志

To investigate the serological and genetic characteristics of para-Bombay patients in a hospital in Hunan Province. A retrospective analysis was conducted on the blood type results of 175 439 hospitalized patients born in Hunan Province from the Third Xiangya Hospital, Central South University from 2016 to 2021. Phenotypes of ABO blood group was analyzed by blood group serology, and molecular biological methods were used to analyze the genotype, including ABO genotyping by polymerase chain reaction-sequence specific primers (PCR-SSP) and fucosyltransferase 1 (FUT1) and fucosyltransferase 2 (FUT2) gene sequencing. The results showed that 3 cases of Ah and 1 case of Bh were detected. FUT1 sequencing showed that there were 2 cases of h3h3, 1 case of h1h1 and 1 case of h302h1, of which h302 (c.302C>T) was the first discovered mutation. FUT2 sequencing revealed that 4 cases were all Se357Se357. The pedigree study showed that the inheritance of para-Bombay blood group was consistent with autosomal dominant inheritance. In conclusion, the FUT1 gene mutations leading to para-Bombay blood group mainly include h3, h1 and h302, of which h3 mutation is the most common.

Identification of Complex and Combined Antibody Consisted of Anti-c, Anti-E, Anti-Jka and Anti-Fya / 中国实验血液学杂志

OBJECTIVE@#To investigate the role of multiple serological methods in the identification of complex antibodies.@*METHODS@#The blood group antigens were detected by saline and microcolumn agglutination methods. The saline method was used to screen and identify IgM-type antibodies in the patient's serum, while the polybrene, anti-globulin, microcolumn agglutination, enzymic and absorption-elution methods were used to screen and identify IgG-type antibodies.@*RESULTS@#The patient was B/CCDee/Jk(a-b+)/Fy(a-b+) blood type. The serum reacted with panel cells, and the reaction presented anti-E pattern in the saline medium. It was fully positive in the microcolumn agglutination card, except 2 negative ones after using papain to treat the panel cells. Referring to the pattern table, it was concluded that there existed anti-c, anti-E, and anti-Jka antibodies, and one antibody corresponding to an antigen that was easily destroyed by papain. The red blood cells with specific phenotype were selected for absorption-elution to identify IgG-type anti-c, anti-E, anti-Jka and anti-Fya antibodies.@*CONCLUSION@#It is confirmed that IgM-type anti-E, and IgG-type anti-c, anti-E, anti-Jka and anti-Fya antibodies exist in the patient's serum by multiple serological methods.

Genetic analysis of a child with Complex cortical dysplasia with other brain malformations type 6 due to a p.M73V variant of TUBB gene / 中华医学遗传学杂志

OBJECTIVE@#To explore the genetic basis for a child with multiple malformations.@*METHODS@#A child who had presented at Shanxi Provincial Children's Hospital in February 2021 was selected as the study subject. Clinical data of the patient was collected, and whole exome sequencing (WES) was carried out to screen pathogenic variants associated with the phenotype. Candidate variant was validated by Sanger sequencing of her family members.@*RESULTS@#The child had normal skin, but right ear defect, hemivertebral deformity, ventricular septal defect, arterial duct and patent foramen ovale, and separation of collecting system of the left kidney. Cranial MRI showed irregular enlargement of bilateral ventricles and widening of the distance between the cerebral cortex and temporal meninges. Genetic testing revealed that she has harbored a heterozygous variant of NM_178014.4: c.217A>G (p.Met73Val) in the TUBB gene, which was unreported previously and predicted to be likely pathogenic based on the guidelines from the American College of Medical Genetics and Genomics (ACMG). The child was diagnosed with Complex cortical dysplasia with other brain malformations 6 (CDCBM6).@*CONCLUSION@#CDCBM is a rare and serious disease with great genetic heterogeneity, and CDCBM6 caused by mutations of the TUBB gene is even rarer. Above finding has enriched the variant and phenotypic spectrum of the TUBB gene, and provided important reference for summarizing the genotype-phenotype correlation of the CDCBM6.

Screening and obataining of aptamers for the blood group antigen-binding adhesin (BabA) to block Helicobacter pylori (H.pylori) colonization in the stomach of mice / 细胞与分子免疫学杂志

Objective To explore the aptamer specific binding blood group antigen-binding adhesin (BabA) of Helicobacter pylori (H.pylori) for blocking of H.pylori adhering host cell. Methods H.pylori strain was cultured and its genome was extracted as templates to amplify the BabA gene by PCR with designed primers. The BabA gene obtained was cloned and constructed into prokaryotic expression plasmid, which was induced by isopropyl beta-D-galactoside (IPTG) and purified as target. The single stranded DNA (ssDNA) aptamers that specifically bind to BabA were screened by SELEX. Enzyme-linked oligonucleotide assay (ELONA) was used to detect and evaluate the characteristics of candidate aptamers. The blocking effect of ssDNA aptamers on H.pylori adhesion was subsequently verified by flow cytometry and colony counting at the cell level in vitro and in mouse model of infection, respectively. Meanwhile, the levels of cytokines, interleukin 6 (IL-6), IL-8, tumor necrosis factor α (TNF-α), IL-10 and IL-4 in the homogenate of mouse gastric mucosa cells were detected by ELISA. Results The genome of H.pylori ATCC 43504 strains was extracted and the recombinant plasmid pET32a-BabA was constructed. After induction and purification, the relative molecular mass (Mr) of the recombinant BabA protein was about 39 000. The amino acid sequence of recombinent protein was consistent with BabA protein by peptide mass fingerprint (PMF). Five candidate aptamers were selected to bind to the above recombinent BabA protein by SELEX. The aptamers A10, A30 and A42 identified the same site, while A3, A16 and the above three aptamers identified different sites respectively. The aptamer significantly blocked the adhesion of H.pylori in vitro. Animal model experiments showed that the aptamers can block the colonization of H.pylori in gastric mucosa by intragastric injection and reduce the inflammatory response. The levels of IL-4, IL-6, IL-8 and TNF-α in gastric mucosal homogenates in the model group with aptamer treatment were lower than that of model group without treatment. Conclusion Aptamers can reduce the colonization of H.pylori in gastric mucosa via binding BabA to block the adhesion between H.pylori and gastric mucosal epithelial cells.

Susceptibilité d'appartenance à un groupe sanguin spécifique du système Abo des personnes atteintes de COVID-19 à l'Institut national de Santé Publique (INSP) en 2020 / Susceptibility of ABOS blood groups to COVID-19 at the National Institute of Public Health (INSP) Of Mali In 2020

Introduction: Plusieurs auteurs ont suggéré une association entre le système ABO (SABO) et le risque d'infection au SRAS CoV-2. La présente étude avait pour objectif d'identifier la susceptibilité des groupes sanguins du SABO au COVID-19à l'Institut National de Santé Publique (INSP) du Mali. Matériel et méthodes : Il s'agissait une étude cas-témoins non appariée. Les cas (402) étaient des patients COVID-19 et les témoins (5438) des pèlerins musulmans tous ayant fait le groupage sanguin ABO à l'INSP. Une régression logistique fut réalisée afin d'identifier les facteurs associés au statut infectieux à SRAS-CoV-2en utilisant le logiciel SPSS version25. Résultats: Les groupes sanguins avaient les fréquences suivantes : O(34%), B(30%), A(28%), AB(8%) pour les cas et O(42%), B(27%), A(25%), AB(6%) pour les témoins. Le statut COVID-19 positif n'était pas significativement associé aux groupes sanguins A(OR=1,17; IC95%[0,93-1,47]), B(OR=1,11; IC95%[0,89-1,39]) et AB(OR=1,41; IC95%[0,97-2,06]). Cependant, les sujets du groupe sanguin O étaient 28 fois moins susceptibles de faire la COVID-19 que les non O(OR=0,72; IC95%[0,58-0,89). Conclusion: Les résultats suggèrent que les personnes du groupe sanguin O étaient moins susceptibles de faire l'infection par le SRAS CoV-2 que les non O. Cela ne devrait pas influer sur l'utilisation des mesures barrières au sein des groupes SABO.

Introduction: Several authors have suggested an association between the ABO system (ABOS) and the risk of SARS CoV-2 infection. The objective of the present study was to identify the susceptibility of ABOS blood groups to COVID-19 at the National Institute of Public Health (INSP) of Mali. Material and methods: This was an unpaired case-control study. The cases (402) were COVID-19 patients, and the controls (5438) were Muslim pilgrims, all of whom had undergone ABO blood grouping at the INSP. Logistic regression was performed to identify factors associated with SARS-CoV-2 infection status using SPSS version25 software. Results: Blood types had the following frequencies: O(34%), B(30%), A(28%), AB(8%) for cases and O(42%), B(27%), A(25%), AB(6%) for controls. COVID-19 positive status was not significantly associated with blood groups A(OR=1.17; CI95%[0.93-1.47]), B(OR=1.11; CI95%[0.89-1.39]) and AB(OR=1.41; CI95%[0.97-2.06]). However, blood group O subjects were 28 times less likely to have COVID-19 than non-O(OR=0.72; CI95%[0.58-0.89). Conclusion: The results show that blood group O individuals were less likely to have SARS CoV-2 infection than non-O individuals. This should not affect the use of barrier measures in ABOS groups.

Qualité de la consultation prénatale chez les patientes admises en salle d'accouchement à la maternité du CHU de la Mère et de l'Enfant de N'Djamena / NA

Introduction : L'OMS dans les dernières recommandations exige 8 contacts dans l'optique de minimiser les risques afin d'assurer aux gestantes leurs fœtus un bon pronostic. Objectif: Analyser la qualité des CPN chez les gestantes Méthodologie : Il s'agissait d'une étude transversale prospective et analytique d'une durée de trois mois (juillet à septembre 2019) portant sur l'évaluation de la qualité des CPN chez les parturientes à la maternité du CHU de la mère et de l'enfant de Ndjamena (Tchad). La CPN est de qualité si la gestante réalise au moins 8 CPN et la prévention contre le tétanos, le paludisme, l'anémie, le traitement des parasites intestinaux et la transmission des maladies telles que le VIH et l'hépatite B. Toute parturiente (terme ≥ 28 SA) ayant pratiqué au moins une CPN et consentante au moment de l'enquête était incluse dans l'étude. Résultats : La fréquence des patientes ayant fait au moins un contact prénatal était de 68,11%. Les patientes ayant fait 4 contacts étaient les plus représentées avec 31%. La majorité des parturientes avait bénéficié de la prévention contre le paludisme (96,8%), de l'anémie (93%) du tétanos néonatale (85,8%) et du déparasitage (79,2%). Les bilans biologiques les plus réalisés étaient, GS/RH, la sérologie VIH, NFS, AgHbs respectivement 91%, 84%, 82%, et 68%. Le mode d'accouchement par césarienne était plus observé chez les patientes ayant réalisé un et deux contacts avec respectivement 23% et 19,4%. La létalité périnatale était plus rapportée chez les nouveau-nés des parturientes ayant réalisé 1 et 2 contacts avec respectivement 17% et 8%. Conclusion: La réalisation des huit contacts tels que recommande l'OMS pas encore d'actualité.

Introduction: The WHO in the latest recommendations requires 8 contacts in order to minimize the risks to ensure a good prognosis for patients and their fetuses. Objective: To analyze the quality of prenatal consultation in parturient Method: This was a prospective and analytical cross-sectional study covering a period of three months (July to September 2019) to assess the quality of prenatal consultations among parturient admitted at the mater intestinal parasites and transmission of diseases such as HIV and hepatitis B. Any parturient (term ≥ 28 SA) who had performed at least one prenatal consultation and consented to participate at this study was included. Results: The frequency of patients that had attended at least one prenatal contact was 68.11%. The majority of parturient had received the prevention for malaria (96.8%), anaemia (93%), neonatal tetanus (85.8%) and deworming (79.2%). Mains biological exam performed were: blood group, GS/RH, HIV, blood formula, hepatitis B detection respectively 91%, 84%, 82%, and 68%. The delivery by caesarean section was more performed by caesarean section among patients who had attended one and two contacts respectively 23% and 19.4%. Perinatal lethality was morenity of N'Djamena Mother and Child University hospital (NMCUH). ANC is of good quality if the pregnant woman performs at least 8 ANC and prevention of tetanus, malaria, anemia, treatment of reported in newborns of parturient who had attended one and two contacts respectively 17% and 8%. Conclusion: The completion of the eight contacts as recommended by the WHO is not yet complete.

Investigation of ABO and RhD blood groups in childbearing age people in rural areas of Yunnan Province / 中华预防医学杂志

The participants in this study were 20-49 years old rural childbearing age people who received the National Free Preconception Health Examination Project (NFPHEP) in Yunnan Province during 2013 to 2019. The proportion of ABO and RhD blood groups among different ethnic groups and different areas were calculated. The proportion of 2 748 131 participants with blood group A phenotype was highest (32.60%), followed by O (30.60%), B (27.33%) and AB (9.47%). In the RhD blood system, the proportion of the RhD positivity (RhD+) and RhD negativity (RhD-) group were 99.29% and 0.71% respectively. The proportions blood groups were significantly different among ethnic groups and areas (all P<0.001). Among 18 ethnic groups with more than 3 000 participants, Yao (42.75%), Bouyei (40.58%) and Dai (40.37%) ethnic groups had higher proportion of blood group O phenotype than other ethnic groups. Wa ethnic groups had highest proportion of the A (40.15%) and AB phenotypes (11.23%). Miao ethnic group (34.70%) and Lahu ethnic group (34.42%) had higher proportion of blood group B phenotype than other ethnic groups. Wa ethnic group had the highest proportion of RhD-group (1.88%). In all 16 prefectures of Yunnan, the proportion of blood group O phenotype was highest in Xishuangbanna Dai Autonomous Prefecture (40.27%). Baoshan city (36.39%), Lincang city (36.22%) and Dali Bai autonomous prefecture (36.06%) had higher proportion of blood group A phenotype than other regions. Diqing Tibetan Autonomous Prefecture (30.83%) and Qujing city (30.48%) had higher proportion of blood group B phenotype than other areas, while Zhaotong city had a highest proportion of blood group AB phenotype (11.19%). The proportion of RhD-group was highest in Honghe hani and Yi nationality autonomous prefecture(1.37%). The A RhD+(39.36%), A RhD-(0.78%), AB RhD+(11.03%), AB RhD-(0.20%) and O RhD-(0.48%) blood groups were higher proportion in Wa ethnic group than in other ethnic groups (P<0.001).

Serological characteristics and molecular mechanism of an individual with p phenotype / 中华医学遗传学杂志

OBJECTIVE@#To analyze the serological characteristics and molecular mechanism for an individual with p phenotype.@*METHODS@#An individual with p phenotype upon blood group identification at Jiaxing Blood Center in May 2021 was analyzed. ABO, RhD and P1PK blood groups and irregular antibodies in her serum were identified using conventional serological methods. The encoding region of α1, 4-galactosyltransferase gene (A4GALT) encoding P1 and Pk antigens was analyzed by polymerase chain reaction-sequence-based typing (PCR-SBT).@*RESULTS@#The individual was A group, RhD positive and had a p phenotype of the P1PK blood group system. Anti-PP1Pk was discovered in her serum. Sequencing analysis revealed that she has harbored a homozygous c.343A>T variant of the A4GALT gene.@*CONCLUSION@#The homozygous c.343A>T variant of the A4GALT gene probably underlay the p phenotype in this individual.

Analysis of Irregular Blood Group Antibody Distribution and Blood Transfusion Efficacy in Patients with Malignant Tumor / 中国实验血液学杂志

OBJECTIVE@#To investigate the distribution of irregular blood group antibodies in patients with malignant tumors, and to analyze the relationship between it and efficacy of blood transfusion in patients.@*METHODS@#5 600 patients with malignant tumors treated in Shanxi Bethune Hospital from January 2019 to December 2021 were selected as the research subjects. All patients received blood transfusion, and cross matching test was conducted before blood transfusion, irregular antibody results of patients were tested; the irregular distribution of blood group antibodies was observed, and the relationship between it and efficacy of blood transfusion in patients was analyzed.@*RESULTS@#Among 5 600 patients with malignant tumors, 96 cases were positive for irregular antibody, and the positive rate was 1.71%; the main blood group systems involved in the irregular antibody positive of 96 patients with malignant tumors were RH, MNSs and Duffy system, among which Rh blood group was the most common, and the proportion of anti-E was the highest; among the malignant tumor patients with positive blood group irregular antibody, the proportion of female was higher than that of male; the proportion of patients aged >60 years was the highest, followed by patients aged >40 and ≤50 years, and the proportion of patients aged 18-30 years was the lowest; the patients with positive blood group irregular antibody were mainly in blood system (including lymphoma), digestive system, reproductive and urinary system; the positive rate of irregular antibody of patients in the ineffective group was higher than that of patients in the effective group, the difference was statistically significant (P<0.05). Logistic regression analysis results showed that, irregular antibody positive was a risk factor for ineffective blood transfusion in patients with malignant tumor (OR>1, P<0.05).@*CONCLUSION@#The irregular blood group antibody positive of patients with malignant tumor are mostly female, and the proportion of patients aged >60 is the highest, which is mainly distributed in malignant tumors of blood system, digestive system and urogenital system, and the positive blood group irregular antibody is related to the efficacy of blood transfusion in patients.

Retrospective Analysis of Irregular Antibodies Causing Hemolytic Disease of the Fetus and Newborn in Jiangxi Province / 中国实验血液学杂志

OBJECTIVE@#To analyze the characteristics of antibody-specific distribution, laboratory detection results of hemolytic disease of the fetus and neonatal(HDFN) caused by irregular blood group antibodies other than ABO, and its correlation with the clinical situation.@*METHODS@#The non-ABO-HDFN cases in our hospital from October 2012 to December 2021 were selected as the research objects, and the cases diagnosed with ABO-HDFN in the same period were randomly selected as the control group, and the data of antibody specific distribution, total bilirubin, direct antibodies, maternal history, age of the children, the presence or absence of combined ABO-HDFN, and whether to exchange/transfuse blood were retrospectively analyzed. The characteristics of non-ABO-HDFN in Jiangxi province were analyzed.@*RESULTS@#The detection rate of non-ABO-HDFN in Jiangxi province increased. Among 187 non ABO-HDFN cases, the highest percentage of Rh-HDFN was detected (94.6%). Compared with the control group of ABO-HDFN, the non-ABO-HDFN had higher mean integral value of direct antibody, higher peak total bilirubin, and longer duration. Anti-M-HDFN may have severe disease but the direct antibody weak positive/negative, it was easy missed in clinical and delayed the treatment. There is no correlation between the specificity of irregular antibodies, the sex of the child, the mother's previous childbirth history, the presence or absence of combined ABO-HDFN and the need for blood exchange/transfusion(P>0.05).@*CONCLUSION@#The irregular antibodies of causing non ABO-HDFN in Jiangxi area are mainly Rh blood group system, followed by MNS blood group system. Understanding the characteristics of HDFN disease, serological features and the correlation with clinical indexes will help to detect and treat non ABO-HDFN in time and reduce the risk of complications.

Correlation Analysis of Hemolytic Transfusion Reaction Induced by Low Titer Antibody / 中国实验血液学杂志

OBJECTIVE@#To establish the diagnostic process of low titer blood group antibody in the occurrence of adverse reactions of hemolytic transfusion.@*METHODS@#Acid elusion test, enzyme method and PEG method were used for antibody identification. Combined with the patient's clinical symptoms and relevant inspection indexes, the irregular antibodies leading to hemolysis were detected.@*RESULTS@#The patient's irregular antibody screening was positive, and it was determined that there was anti-Lea antibody in the serum. After the transfusion reaction, the low titer anti-E antibody was detected by enhanced test. The patient's Rh typing was Ccee, while the transfused red blood cells were ccEE. The new and old samples of the patient were matched with the transfused red blood cells by PEG method, and the major were incompatible. The evidence of hemolytic transfusion reaction was found.@*CONCLUSION@#Antibodies with low titer in serum are not easy to be detected, which often lead to severe hemolytic transfusion reaction.

Frequency of antigen Dia on the blood donor population of the Hemocenter coordinator of the Hemopa Foundation

ABSTRACT Introduction: Erythrocyte phenotyping is a very important test in the adoption of prophylactic measures to reduce transfusion reactions/alloimmunizations in polytransfused patients. The blood group Diego, in its current, form has 22 antigens, of which 4 are immunogenic, being Dia/Dib and Wra/Wrb, while the others are less expressive. The antigen Dia is of low incidence among whites and blacks, however, it is common in the South American indigenous and Asian Mongolian populations. It is also considered a system of clinical importance for its immunogenicity. Method: The present study aimed to carry out a retrospective and descriptive survey of the frequency of the Dia antigen in the blood donor population at the HEMOPA Foundation Coordinating Blood Center from 12/2018 to 1/2000. The data obtained were from the HEMOPA Foundation SBS Progress and SBS WEB Systems databases. Results: During this period, 941,744 blood bags were collected and, of these, 930 bags were phenotyped for the Dia antigen, of which 842 were negative and 88 (9.7%) positive. The research showed that, among the positive donors for the antigen Dia, 88.6% were brown, 3.4%, black and 8%, white. In the statistical analysis, the frequency observed was higher in browns. Conclusion: In the present investigation, we concluded that our region has a relatively higher frequency of the Dia antigen, when compared to the rest of Brazil, and it occurs more often in browns.