Variant RHD Types in Brazilians With Discrepancies in RhD Typing

J Clin Lab Anal. 2016 Nov;30(6):845-848. doi: 10.1002/jcla.21946. Epub 2016 Apr 13.

Abstract

Background: The knowledge of D variants in patients and donors is important because anti-D alloimmunization can occur in some but not all individuals who express a variant RHD allele. Serologic distinction of RhD discrepancies is not always straightforward, which makes molecular analysis highly desirable.

Methods: A group of 223 subjects, 129 patients, and 94 blood donors was identified and analyzed on the basis of a D typing discrepancy. The D antigen expression was evaluated by tube and gel hemagglutination with four anti-D reagents. PCR-single specific primer (SSP), multiplex PCR, RHD BeadChip (Immucor), or sequencing were used for molecular analysis.

Results: In total, 168/223 (75%) weak D and 55/223 (25%) partial D variants were identified. Hemagglutination results varied in methods and anti-D reagents used in this process. There was no standard serologic reactivity identified, which could predict what type of D variant would be identified. Among weak D samples, types 1-3 were the most common, while DAR and DVI were most prevalent among partial D samples.

Conclusion: Our results show that discrepancies found in the serologic typing should be investigated by molecular methods in order to determine the D variant involved and also to distinguish between weak D and partial D. The knowledge of the distribution of weak D types and partial D among populations is important for D- patients and pregnant women management.

Keywords: RhD; hemagglutination; molecular analysis; partial D; weak D.

MeSH terms

  • Blood Donors
  • Blood Grouping and Crossmatching / methods*
  • Brazil
  • DNA Mutational Analysis
  • Female
  • Gene Frequency
  • Humans
  • Retrospective Studies
  • Rh Isoimmunization / genetics
  • Rh Isoimmunization / immunology
  • Rh-Hr Blood-Group System / genetics*
  • Rh-Hr Blood-Group System / immunology*
  • Rho(D) Immune Globulin / blood*

Substances

  • RHO(D) antibody
  • Rh-Hr Blood-Group System
  • Rho(D) Immune Globulin