Fatal Hydrops Fetalis Caused by Anti-D in a Mother With Partial D

Cannon, Michael J.; Pierce, Richard; Taber, Evan; Schucker, Jodi L.

doi:10.1097/00006250-200311001-00007

Cited by 9 publications

(12 citation statements)

References 6 publications

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“…Subsequently, case reports revealed that some women with a D U phenotype who had been exposed to D+ RBCs by transfusion or pregnancy formed anti-D (Argall et al, 1953;Simmons & Krieger, 1960;Ostgard et al, 1986;Mayne et al, 1991;Domen & Hoetge, 1997). Additional pregnancies were reported that were complicated by RhD haemolytic disease of the fetus and newborn (Hill et al, 1974;Lacey et al, 1983;White et al, 1983;Cannon et al, 2003). To protect RhD-negative women from exposure to the D antigen and forming anti-D (RhD alloimmunization) by transfusion of RBCs from a donor with a D U variant antigen, policies were developed in the United States requiring RBCs from blood donors who tested initially negative by anti-D to be retested with antiglobulin (a "weak D test") (Scientific Committee of the Joint Blood Council & Standards Committee of the American Association of Blood Banks, 1958).…”

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confidence: 99%

Serological weak D phenotypes: a review and guidance for interpreting the RhD blood type using the RHD genotype

2017

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Summary Approximately 0.2% to 1% of routine RhD blood typings result in a “serological weak D phenotype.” For more than 50 years, serological weak D phenotypes have been managed by policies to protect RhD-negative women of child-bearing potential from exposure to weak D antigens. Typically, blood donors with a serological weak D phenotype have been managed as RhD-positive, in contrast to transfusion recipients and pregnant women, who have been managed as RhD-negative. Most serological weak D phenotypes in Caucasians express molecularly defined weak D types 1, 2 or 3 and can be managed safely as RhD-positive, eliminating unnecessary injections of Rh immune globulin and conserving limited supplies of RhD-negative RBCs. If laboratories in the UK, Ireland and other European countries validated the use of potent anti-D reagents to result in weak D types 1, 2 and 3 typing initially as RhD-positive, such laboratory results would not require further testing. When serological weak D phenotypes are detected, laboratories should complete RhD testing by determining RHD genotypes (internally or by referral). Individuals with a serological weak D phenotype should be managed as RhD-positive or RhD-negative, according to their RHD genotype.

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Serological weak D phenotypes: a review and guidance for interpreting the RhD blood type using the RHD genotype

2017

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“…In response to the findings of the CAP TMRC survey, AABB and CAP convened a Work Group on RHD Genotyping and charged it with developing recommendations to clarify clinical issues related to RhD typing in persons with a serologic weak D phenotype. As an initial step for formulating recommendations, the Work Group reviewed the current state of molecular science of RHD , including more than 140 publications covering background; D variants with anti‐D; molecular basis of serologic weak D phenotypes; reviews, editorials, and commentaries; technical resources; and standards and guidelines . This commentary summarizes the proceedings and recommendations of the Work Group.…”

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confidence: 99%

It's time to phase inRHDgenotyping for patients with a serologic weakDphenotype

et al. 2014

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“…Amino acid substitutions in extracellular stretches of the D polypeptide lead to loss of one or more D epitopes (epDs), rendering also partial D individuals prone to anti‐D alloimmunization upon contact with normal D+ RBCs expressing the complete set of epDs. In a number of cases, anti‐D produced in such constellation was responsible for severe or even fatal HDN 1,3 . Weak D types are thought to represent rather quantitative than qualitative D antigen variants.…”

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confidence: 99%