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- Title
Anti-D in RhD Positive Patient: Auto Anti-D or Anti-LW?
- Authors
Hassan, Mohd Nazri; Zulkafli, Zefarina; Wanik, Che Faridah Che; Wan Abd Rahman, Wan Suriana; Noor, Noor Haslina Mohd; Ramli, Marini; Iberahim, Salfarina; Bahar, Rosnah; Yusoff, Shafini Mohamed
- Abstract
Anti-LW and anti-D can be indistinguishable. Therefore, it is important to differentiate them since anti-D is a clinically significant antibody. ICAM4 and RHD genes encode the Landsteiner-Wiener (LW) and RhD antigens, respectively. However, the LW antigens expression requires an interaction with Rh proteins. Hence, LW antigen is being express more strongly by RhD positive (RhD+) than RhD negative (RhD-) individuals. We describe a 51-year-old male with underlying multiple medical problems. His blood group was O RhD+ with Rh phenotype R1r (DCe/dce). The patient had been receiving regular packed cells (PC) transfusion for anemia due to underlying chronic kidney disease. Immunohematology workup showed antibody identification positive for auto-control with anti-D specificity which suggestive for the presence of autoantibody (anti-D or anti-LW). Cross-matching revealed incompatibility with all RhD+ but compatible with RhDPC. Further investigations should be done to differentiate these two antibodies. The laboratory approaches in order to differentiate anti-LW and anti-D will be discussed and highlighted.
- Subjects
BLOOD groups; CHRONIC kidney failure; PHENOTYPES; ANTIGENS; IMMUNOGLOBULINS
- Publication
Gazi Medical Journal, 2021, Vol 32, Issue 1, p128
- ISSN
1300-056X
- Publication type
Article
- DOI
10.12996/gmj.2021.27