Hemolytic Disease of the Newborn Due to Anti‐E^w: A Fourth Example of the Rh Antigen, E^w

The molecular basis of the Rhesus antigen Ew

“…Moreover, Individual 2 is the first E w patient reported to have produced an anti‐E. This may be of practical importance for transfusion medicine because not only an alloantibody can be made by E– individuals against the rare variant E w , 5,8 but that also individuals with the rare variant E w can produce an alloantibody against the wild‐type E. This situation resembles that found in rare individuals carrying distinct partial D antigens presenting with low‐incidence marker antigens and sometimes making an allo‐anti‐D 21 …”

“…One of them, the Rhesus antigen E w (ISBT designation 004 011) was first described by Greenwalt and Sanger in 1955 5 . E w seems to be a rare antigen (<0.1% in Caucasians) and only few reports were published so far 5‐9 . It is defined by a specific antibody, which in some cases is able to cause HDN 5,8 .…”

“…E w seems to be a rare antigen (<0.1% in Caucasians) and only few reports were published so far 5‐9 . It is defined by a specific antibody, which in some cases is able to cause HDN 5,8 . Furthermore, it has been reported, that some, though not all polyclonal anti‐E sera and some anti‐E MoAbs can recognize RBCs carrying the E w antigen 5,7 , 9,10 .…”

The First Example of the Rh Antigen E^w in Western Europe

“…The examined family is of German origin and now living in Baden-Wiirttemberg/FRG. As far as it can be learnt, the family members are not related to the other four families previously described [1][2][3]6], The present family was recognized when the blood of Mrs. H. E. (II-2) showed a remarkable weak agglutination with one anti-E serum in routine Rh typing. Using other anti-E sera, it could be seen that one reaction was negative, while another was positive.…”

Rh Ew antigen in a multi-transfused patient with sickle cell disease

“… 5 According to some reports in the literature, it is only found in Caucasians with a frequency of less than 0.1%. 5 , 6 , 7 , 8 , 9 A hemolytic disease of the newborn (HDN) caused by anti-E w maternal antibodies was reported in two of these reports 5 , 7 ; in another, an anti-E alloantibody was found in an E w positive patient, after receiving E positive red blood cells (RBCs). 6 Although the antigen has been described only in Caucasians (and at a very low frequency), in this study, we found the phenotype with a molecular basis in a patient of mixed ethnicity (neither White nor Black) and sickle cell disease (SCD), highlighting the high level of miscegenation in Brazil.…”