The new low-frequency antigen STEM was identified when a Cape coloured woman with an unknown antibody in her plasma (which agglutinated the red cells of her husband and a minority of other individuals) gave birth to a baby suffering mildly from haemolytic disease of the new-born. Most, but not all, examples of anti-STEM distinguish different strengths of STEM antigen on the red cells of different people; the different strengths are inherited. Family studies established that STEM was inherited as a Mendelian dominant character. STEM subdivides hrS-(Rh: -18, -19) and hrB- (Rh: -31, -34) red cells into two types: STEM+ and STEM-. The manually calculated lod score for STEM being associated with the Rh system is 3.91 and LIPED calculated lod score 4.35. The International Society of Blood Transfusion has allocated STEM the Rh number 49.
A 73-year-old Greek woman presented with symptomatic anaemia requiring red cell transfusion in the setting of progressive chronic lymphocytic leukaemia (CLL). Based on a negative antibody screen, two units of red blood cells (RBCs) were provided for transfusion. During the transfusion, the patient developed an acute haemolytic transfusion reaction (HTR), but recovered with supportive measures. Subsequent antibody investigation confirmed that the patient had an anti-Wb antibody and that the implicated RBC unit was Wb-positive. This is the first report of an anti-Wb causing a clinically significant acute HTR in the literature.
Anti-Gerbich type anti-Ge3 antibodies were identified in the serum of a woman of mixed ethnic origin from Cape Town. The woman had type Ge:-2,-3 (Gerbich) red cells on which there was no evidence of weakened Kell antigens. Her red cells were also Dantu-positive.
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