Male newborn with anti‐Kg antibody‐induced hemolytic disease of the newborn

Kubo, Satomi; Takahashi, Jun; Yoshizawa, Hiroyuki; Ohgitani, Ayako; Ezaki, Toshinobu; Tsubaki, Kazuo; Tani, Yoshihiko; Minowa, Hideki

doi:10.1111/j.1442-200x.2009.02868.x

Cited by 3 publications

(12 citation statements)

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“…3,4 The propositus, a male newborn, was the third of three children. 4 Although there were no significant haematological abnormalities detected in general in the individuals with the Kg-antigen, the newborn displayed severe anaemia (haemoglobin 7Á8 g/dl), a marked increase (510&) in reticulocyte counts and total bilirubin of 14Á2 mg/dl, which is consistent (A) (B) Fig 1. (A) Relative comparison of the protein amounts in the immunoprecipitants.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the Kg-antigen has been clinically presumed to give rise to HDN in the families we reported previously. 4 Severe immune responses against the Rh antigen, including the effector arm of the innate system, are known to be triggered in Rh-negative mothers carrying Rh-positive infants in a second pregnancy after a first pregnancy with an Rh-positive infant. The frequency of the RhD-negative status is 0Á5% in the Japanese population, which is about 15% in the Caucasian population.…”

Section: Discussionmentioning

confidence: 99%

“…In 2009, we reported a propositus with HDN. 4 The Kgantigen was detected in the propositus but not in his mother. In addition, the Kg-antigen was further detected in his two elder brothers (twins) and his father.…”

Section: Introductionmentioning

confidence: 94%

“…Nine samples were obtained from the family members ( Fig S1) 4 and were phenotyped with the anti-Kg antibody purified from the serum of the propositus's mother (II-3), which was kindly provided by Saitama Medical University. 3 Six samples turned out to be Kg-positive, with the remaining three Kg-negative.…”

Section: Serological Analyses Of the Family Members With The Kg-antigenmentioning

confidence: 99%

“…Thus, the Kg-antigen is clinically believed to give rise to HDN. 4 Over 30 years have passed since the Kg-antigen was discovered, however, the polymorphism for this antigen, as well as the determinant gene, have hitherto remained unknown. The molecular nature of the majority of other known antigens responsible for HDN and their determinant genes have been identified but not of the Kg-antigen.…”

Section: Introductionmentioning

confidence: 99%

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The Kg‐antigen, RhAG with a Lys164Gln mutation, gives rise to haemolytic disease of the newborn

et al. 2020

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The Kg-antigen was first discovered in an investigation of a mother whose infant had haemolytic disease of the newborn (HDN). The antibody against the Kg-antigen is believed to be responsible for HDN. The Kg-antigen is provisionally registered under the number 700045, according to the Red Cell Immunogenetics and Blood Group Terminology. However, the molecular nature of the Kg-antigen has remained a mystery for over 30 years. In this study, a monoclonal antibody against the Kg-antigen and the recombinant protein were developed that allowed for the immunoprecipitation analysis. Immunoprecipitants from the propositus' red blood cell ghosts were subjected to mass spectrometry analysis, and DNA sequence analysis of the genes was also performed. A candidate for the Kg-antigen was molecularly isolated and confirmed to be a determinant of the Kg-antigen by cell transfection and flow cytometry analyses. The Kg-antigen and the genetic mutation were then screened for in a Japanese population. The molecular nature of the Kg-antigen was shown to be RhAG with a Lys164Gln mutation. Kg phenotyping further clarified that 0Á22 % of the Japanese population studied was positive for the Kg-antigen. These findings provide important information on the Kg-antigen, which has been clinically presumed to give rise to HDN.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 94%

Section: Serological Analyses Of the Family Members With The Kg-antigenmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Kg‐antigen, RhAG with a Lys164Gln mutation, gives rise to haemolytic disease of the newborn

et al. 2020

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Hemolytic disease of the fetus and newborn

Ross¹,

Waldron²,

Cashore³

et al. 2013

Neonatal Hematology

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DSLK and Kg: Antithetical antigens in the RHAG blood group system, and characterization of anti‐DSLK antibody

et al. 2023

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Background and Objectives The RHAG blood group system contains five antigens: Duclos (RHAG001), Ola (RHAG002), DSLK (RHAG003), Kg (RHAG005) and SHER (RHAG006). Individuals who are DSLK‐negative and Kg‐positive have the same allele RHAG*01.–3, with a single‐nucleotide variation (rs144305805), c.490A>C (p.Lys164Gln), in exon 3 of the RHAG gene. We aimed to confirm whether DSLK and Kg are antithetical antigens. Materials and Methods Blood samples of the original DSLK‐negative proband with anti‐DSLK, her son and another DSLK‐negative individual were examined. The RHAG gene was analysed by polymerase chain reaction and Sanger sequencing. Immunocomplex capture fluorescence assays (ICFAs) and monocyte phagocytosis assays were performed to characterize the anti‐DSLK antibody. Cross‐testing of alloanti‐DSLK and monoclonal anti‐Kg (OSK46) was performed using transduced HEK293 cells by inducing the construct of expression vectors encoding wild‐type RHAG*01 or the variant RHAG*01.–3. Results ICFA using monoclonal anti‐RHAG (LA18.18) revealed that the anti‐DSLK and anti‐Kg antibodies reacted with the wild‐type and variant RhAG (Rh‐associated glycoprotein), respectively. The proband and a DSLK‐negative individual appeared to be homozygous for variant RHAG*01.–3, and the proband's son was typed as RHAG*01/RHAG*01.–3 heterozygote. HEK293 cells with wild‐type RhAG reacted with the anti‐DSLK but not anti‐Kg antibody, whereas HEK293 cells expressing the variant RhAG reacted with the anti‐Kg but not anti‐DSLK antibody. Monocyte phagocytosis assays indicated that 64% of red cells sensitized with anti‐DSLK were phagocytosed by monocytes. Conclusion Our results demonstrate that DSLK and Kg are antithetical antigens in the RHAG blood group system. Anti‐DSLK may be a clinically significant antibody.

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Male newborn with anti‐Kg antibody‐induced hemolytic disease of the newborn

Cited by 3 publications

References 2 publications

The Kg‐antigen, RhAG with a Lys164Gln mutation, gives rise to haemolytic disease of the newborn

The Kg‐antigen, RhAG with a Lys164Gln mutation, gives rise to haemolytic disease of the newborn

Hemolytic disease of the fetus and newborn

DSLK and Kg: Antithetical antigens in the RHAG blood group system, and characterization of anti‐DSLK antibody

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