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Moderate hemolytic disease of the newborn (HDN) due to anti-Rh17 produced by a black female with an e variant phenotype

Brumit, M C; Carnahan, G E; Stubbs, J R; Storry, Jill LU and Reid, M E (2002) In Immunohematology 18(2). p.40-42
Abstract
The Rh blood group antigen e is of high incidence and has many epitopes. Partial expression may occur, more commonly in black persons. Individuals with e variant phenotypes can make antibodies to epitopes they lack. While some of these antibodies may be specific for an antigen, e.g., hrB, others, like anti-Rh17 (anti-Hro), show broader specificity, compatible only with D-- and Rhnull red blood cells (RBCs). Anti-Rh17 in persons of the D-- phenotype has been reported to cause mild to fatal HDN. We report an example of anti-Rh17 produced by a black female with an e variant RBC phenotype that caused moderate HDN. A panel of seven monoclonal anti-e demonstrated her RBCs carried a variant e antigen, and her genotype was RHD, RHce by PCR-RFLP... (More)
The Rh blood group antigen e is of high incidence and has many epitopes. Partial expression may occur, more commonly in black persons. Individuals with e variant phenotypes can make antibodies to epitopes they lack. While some of these antibodies may be specific for an antigen, e.g., hrB, others, like anti-Rh17 (anti-Hro), show broader specificity, compatible only with D-- and Rhnull red blood cells (RBCs). Anti-Rh17 in persons of the D-- phenotype has been reported to cause mild to fatal HDN. We report an example of anti-Rh17 produced by a black female with an e variant RBC phenotype that caused moderate HDN. A panel of seven monoclonal anti-e demonstrated her RBCs carried a variant e antigen, and her genotype was RHD, RHce by PCR-RFLP analysis. Amniotic fluid with.OD450 values from 30 to 35 weeks' gestation predicted moderate HDN probability by the Liley method. At 38+ weeks, a viable 3165 g female infant was delivered. The infant's direct antiglobulin test was 2+ with anti-IgG. Total bilirubin rose to 14.2 mg/dL within 48 hours. Indirect bilirubin peaked at 14.7 mg/dL. The bilirubin responded to triple phototherapy. The infant was discharged on day 6. Potential for infant morbidity due to anti-Rh17- mediated HDN and the importance of specifying risks to women with this antibody if they contemplate pregnancy are discussed. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Immunohematology
volume
18
issue
2
pages
40 - 42
publisher
American Red Cross
external identifiers
  • pmid:15373563
  • scopus:0036273854
ISSN
0894-203X
language
English
LU publication?
yes
id
db84f3c0-16b6-47ca-bf00-e5034dfed25d (old id 1123925)
date added to LUP
2008-05-19 13:34:23
date last changed
2017-01-01 06:56:11
@article{db84f3c0-16b6-47ca-bf00-e5034dfed25d,
  abstract     = {The Rh blood group antigen e is of high incidence and has many epitopes. Partial expression may occur, more commonly in black persons. Individuals with e variant phenotypes can make antibodies to epitopes they lack. While some of these antibodies may be specific for an antigen, e.g., hrB, others, like anti-Rh17 (anti-Hro), show broader specificity, compatible only with D-- and Rhnull red blood cells (RBCs). Anti-Rh17 in persons of the D-- phenotype has been reported to cause mild to fatal HDN. We report an example of anti-Rh17 produced by a black female with an e variant RBC phenotype that caused moderate HDN. A panel of seven monoclonal anti-e demonstrated her RBCs carried a variant e antigen, and her genotype was RHD, RHce by PCR-RFLP analysis. Amniotic fluid with.OD450 values from 30 to 35 weeks' gestation predicted moderate HDN probability by the Liley method. At 38+ weeks, a viable 3165 g female infant was delivered. The infant's direct antiglobulin test was 2+ with anti-IgG. Total bilirubin rose to 14.2 mg/dL within 48 hours. Indirect bilirubin peaked at 14.7 mg/dL. The bilirubin responded to triple phototherapy. The infant was discharged on day 6. Potential for infant morbidity due to anti-Rh17- mediated HDN and the importance of specifying risks to women with this antibody if they contemplate pregnancy are discussed.},
  author       = {Brumit, M C and Carnahan, G E and Stubbs, J R and Storry, Jill and Reid, M E},
  issn         = {0894-203X},
  language     = {eng},
  number       = {2},
  pages        = {40--42},
  publisher    = {American Red Cross},
  series       = {Immunohematology},
  title        = {Moderate hemolytic disease of the newborn (HDN) due to anti-Rh17 produced by a black female with an e variant phenotype},
  volume       = {18},
  year         = {2002},
}