Two Examples of an Inseparable Antibody That Reacts Equally Well with D^W+ and Rh32+ Red Blood Cells

Abstract

We suggest that amino acids encoded by nucleotides at the junction of exon 4 of RHD to exon 5 of RHCE may induce a conformation that is recognized by these equally reactive inseparable antibodies. Until such time that the epitope recognized by these antibodies is defined, we recommend use of the descriptive name anti-DW/Rh32.

A new hybrid RHCE gene (CeNR) is responsible for expression of a novel antigen

“…More recently, her RBCs were agglutinated by a serum containing an inseparable anti-D W /Rh32. 8 This suggested that her RBCs carry a novel low-prevalence antigen and that the molecular background for the D(C)C W (e)/D--phenotype in this family was different from those previously reported. The purpose of this study was to determine the molecular basis of the Rh phenotype in this well-studied serologic case.…”

“…NR has been studied several times over the years, deposits autologous units for transfusion, and, as a nurse, has remained interested in her unusual phenotype. More recently, her RBCs were agglutinated by a serum containing an inseparable anti‐D W /Rh32 8 . This suggested that her RBCs carry a novel low‐prevalence antigen and that the molecular background for the D(C)C W (e)/D‐‐ phenotype in this family was different from those previously reported.…”

“…Eluates were prepared with an acid elution method (Gamma Elu‐KitII, Gamma Biologicals, Inc., Houston, TX). The SR serum has been previously well characterized and contains an antibody that reacts equally well with Rh32+ and D W + RBCs and these specificities cannot be separated 8 …”

Rh and RHAG Blood Group Systems

“…Most anti -D w , however, also react with Rh:32 cells, some reacting only weakly with the Rh:32 cells and some reacting as strongly with Rh:32 cells as with D w + cells [552] . Most anti -D w , however, also react with Rh:32 cells, some reacting only weakly with the Rh:32 cells and some reacting as strongly with Rh:32 cells as with D w + cells [552] .…”

A D+ blood donor with a novel RHD*D‐CE(5‐6)‐D gene variant exhibits the low‐frequency antigen RH23 (DW) characteristic of the partial DVa phenotype

“…LFAs are immunogenic and antibodies to RH23 (D W ) and Rh32 can cause hemolytic disease of the fetus and newborn . Formation of these LFAs is thought to be due to the interaction of amino acids encoded by RHD Exon 4 and RHCE Exon 5 . DV and DBT cells are defined by two distinct characteristic patterns of reaction against a panel of anti‐D MoAbs …”