Background
D antigen is one among the most immunogenic antigens and is the most common cause of Haemolytic Disease of Fetus and Newborn (HDFN). The D‐phenotype is a rare Rh variant in which none of the RhCE antigens are expressed on the red cell surface. Individuals having D‐phenotype are capable of producing a rare alloantibody named as anti‐Rh17(Hr°) in response to pregnancy or transfusion and has the potential to react with C/c and E/e antigens causing severe haemolytic transfusion reaction (HTR) and haemolytic disease of fetus and newborn (HDFN).
Case report
We have encountered a case of severe HDFN with an accidental discovery of D‐ phenotype of the mother with anti‐Rh‐17 antibodies. D‐ phenotype has been confirmed with molecular typing along with genotyping of all family members.
Conclusion
Rare phenotypes like D‐ individuals especially if allo‐immunised are of great concern at times of transfusion requirements. Hence, proper identification of these individuals are important to contribute them to the rare donor pool and to adopt adequate patient blood management strategies.
Background: The blocking of D antigen sites of RBC membrane of the fetus by the passively transferred IgG anti-D in cases of Hemolytic Disease of fetus and new born (HDFN) is called blocked- D phenomenon. The coating of maternal IgG type of anti-D prevents the agglutination of the Rh-(D) antigen positive red blood cells (RBC) by the IgM D-antigen typing reagents. We are reporting two cases of Rh-(D) HDFN which were falsely typed as Rh (D) antigen negative with routine typing reagents and had multiple allo-antibodies in the maternal serum. Aims: To rule out HDFN and to confirm the Rh-(D) status of baby, to detect the presence of other allo-antibodies in the maternal serum that can complicate future transfusions in mother. Materials: After routine blood grouping, sample of baby was subjected to adsorption-elution studies and maternal serum was used for antibody screening and identification Results: In both the cases, blocked-D phenomenon got detected and there were multiple anti-rhesus antibodies other than anti-D in the maternal serum. Conclusion: Antibody identification in antenatal women is important in the case management of HDFN to protect future pregnancies and to avoid the risk of mismatched transfusions.
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