Unexplained Appearance of Antibody in an Rh(null) Donor

Abstract

A blood donor of the phenotype Rh(null) was found at his 6th donation to have an antibody which had not been there before: he had never been transfused. The antibody reacts by the saline, albumin and enzyme methods but not by the antiglobulin (IgG). It reacted with all cells tested except the donor's own and those of two available Rh(null) people and, surprisingly, those of three available -D-/-D- people: it is apparently directed at the CcEe part of the Rh antigen complex. Like other Rhmiii propositi the donor has a compensated anaemia and his s and U antigens give some abnormal reactions. His parents are second cousins. Serological and pedigree evidence did not disclose his type of Rh(null), ‘regulator' or amorph.

Anti-Rh 29 in a Primigravida with Rhesus Null Syndrome Resulting in Haemolytic Disease of the Newborn

“…The haemoglobin dropped during pregnancy but not low er than 10 g/dl; anaemia in a number of previous reports [5,6,[8][9][10]14], however, was mild to moderate and characteristically compensated although on one occasion it was fairly severe [7], The mean corpuscular fragility was slightly shifted to the right of the normal control but the membrane lesion became more evident after incubation. This unexpected good osmotic resistance was reflected in the favourable recovery of a small frozen volume of her red cells.…”

“…Haemolysis has also been reported to increase during pregnancy [7]. Many of these individuals developed antibodies to basic Rh anti genic structures following transfusion [8] or in response to pregnancy [9] but in some the antibodies were naturally occurring [10,11].…”

Rh and RHAG Blood Group Systems

“…Anti -Rh29 has been made by people with Rh null of both types, though not all Rh null individuals make anti -Rh29 when immunised; two Rh null sisters had no Rh antibody although they had a total of nine children. Antibodies in the sera of two Rh null donors who had received no known immunising stimulus behaved as anti -Hr o , reacting with all red cell samples save those of Rh null and D --phenotypes [530,531] . Antibodies in the sera of two Rh null donors who had received no known immunising stimulus behaved as anti -Hr o , reacting with all red cell samples save those of Rh null and D --phenotypes [530,531] .…”

Short duplication within theRHCEgene associated with an in cis deletedRHDcausing aRhnullamorph phenotype in an immunized pregnant woman with anti‐Rh29

“…The degree of anemia in Rh null subjects varies from mild to moderate in different individuals and even in the same individual. Rh null individuals rarely develop antibodies without stimulation and most cases occur in response to pregnancy or transfusion. Subjects with Rh null RBCs readily produce alloantibodies to high‐prevalence Rh antigens.…”