Analysis of Partial D Subtypes by Various Anti-D Reagents / 대한수혈학회지

BACKGROUND: There are some previous reports about partial D in Korea. However, the frequency of the partial D in Korea is still unknown. In this study, subtypes of partial D were analyzed by the use of various commercially available anti-D reagents. METHODS: We collected 273 cases determined as RhD negative by RhD typing using the tube method with monoclonal IgM/IgG anti-D reagent (Bioscot. Livingston, UK) from 80,062 cases that were screened between January 2004 and August 2007. The cases were divided into three periods (I, II, III), according to the manufacturers and numbers of anti-D reagents used. A weak D test was performed by using the tube method with various anti-D reagents. The cases with different reactivity between anti-D reagents were determined as partial D, and further analyzed the subtypes by reactivity patterns according to the target epitope of anti-D reagents. An additional test using the ID-Partial D Typing Card (DiaMed, Cressier, Switzerland) was conducted during period III. RESULTS: Five cases showed reactivity patterns of weak D and 16 cases showed reactivity patterns of partial D. Ten cases of partial D were typed as DVI and three cases were typed as DFR. During period III, five cases were typed as DVI and one case was typed as DFR. These results were different from the results obtained with the use of the ID-Partial D Typing Card. CONCLUSION: DVI, which is the most common subtype of partial D, is also common in Korea. Therefore, RhD typing and a weak D test should be performed using combined anti-D reagents that enable the differentiation of DVI from other subtypes.

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.