We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Auto-Anti D Antibody in a Multiply Transfused Thalassaemia Patient at Universiti Kebangsaan Malaysia Medical Centre: A Case Report.
- Authors
Yousuf, Rabeya; Tang Yee Loong; Aziz, Suria Abdul; Yusof, Nurasyikin; Thalith, Nor Fadzliana Abdullah; Leong Chooi Fun
- Abstract
Objective: A rare case of autoantibody against D-antigen is reported here. A 15-year-Malay girl, diagnosed as Hb E/ p-thalassaemia at the age of one and underwent splenectomy at the age of seven presented to Universiti Kebangsaan Malaysia Medical Centre (UKMMC) for anaemia. Results: Investigations showed her blood group as O-RhD-positive with possible RlRIgenotype. Her antibody screening was positive and antibody identification confirmed an anti-D antibody. Repeated RhD grouping with monoclonal IgM/IgG anti-D typing reagent showed strong reactions which excluded the partial-D status as IgM-monoclonal anti-D component directly agglutinates RhD-positive RBC and most types of Du except DviVariant. The DviVariant has been excluded by testing with ID-Card "DiaClon ABO/D+reverse grouping for patients". The direct antiglobulin test was positive and eluate showed presence of anti-D antibody. A differential-diagnosis of auto-anti-D or anti-LW was considered. Further investigation was performed to exclude anti-LW by testing patient's serum and eluate with RhD-positive and RhD-negative cord blood cells. Both the patient's serum and eluate showed positive reactions with only RhD-positive cord-blood cells but not with RhD-negative cells; indicating the antibody is of anti-D specificity and not anti-LW. As the patient's serum and eluate showed an anti-D antibody but patient's red-cell confirmed the presence of D-antigen, a diagnosis of autoanti-D was made and crossmatched compatible group O-RhD-negative packed cell released for transfusion. Conclusion: We would like to highlight two important aspects from this case i) it is very important to determine the RhD-phenotype especially for patients at child bearing age ii) auto-anti-D must be differentiated from anti-LW antibody as weak anti-LW may be confused with anti-D.
- Subjects
MALAYSIA; THALASSEMIA diagnosis; ACADEMIC medical centers; AUTOANTIBODIES; BLOOD transfusion; DIFFERENTIAL diagnosis; SYMPTOMS
- Publication
International Medical Journal, 2016, Vol 23, Issue 5, p596
- ISSN
1341-2051
- Publication type
Article