Mild Hemolytic Disease of the Newborn due to Anti-Lewis^a

Vescio, Luis A. Carreras; Torres, Oscar W.; Virgilio, Olga S.; Pizzolato, Marco

doi:10.1159/000462347

Cited by 8 publications

(2 citation statements)

References 3 publications

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“…A similar finding was also observed in this study, where conventional RBC phenotyping through the tube technique was found to be incapable of determining accurate Lewis phenotypes. Although the Lewis system is not considered to be of major interest in modern blood banking as Lewis antibodies have rarely been implicated in haemolytic transfusion reactions and haemolytic disease of the newborn, 14‐16 this system has been associated with a number of diseases, 11 and hence, the data must not be skewed due to the non‐genuine RBC phenotypes.…”

Section: Discussionmentioning

confidence: 99%

Divergence in phenotyping and genotyping analysis of the Lewis histo‐blood group system

Donta

Gorakshakar

Ghosh

2021

Transfusion Medicine

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Objectives This study evaluated the red blood cell (RBC) Lewis phenotypes by simple haemagglutination technique and molecular genotyping in healthy individuals. Background The expression of Lewis antigen on RBCs is dependent on the interaction of FUT3 and FUT2 genes. Complexity of the genetic control of Lewis antigen expression and the error‐prone nature of Lewis phenotyping result in non‐genuine RBC Lewis phenotypes, which could be misleading. Materials and Methods ABO blood group and RBC Lewis phenotypes were determined by conventional haemagglutination tube techniques. FUT2 and FUT3 genotypes were analysed by polymerase chain reaction and direct DNA sequencing. The RBC Lewis phenotypes were also inferred from the FUT2 and FUT3 genotyping results. Results The frequencies of RBC Lewis phenotypes typed by the conventional tube test were Le(a+b−) 19.63%, Le(a−b+) 49.32% and Le(a−b−) 31.05%, whereas the frequencies inferred from the FUT2 and FUT3 genotypes were Le(a+b−) 20.09%, Le(a−b+), 59.82%; Le(a−b−), 17.81%; and Le(a+b+), 5 (2.28%). The Le(a+b+) phenotype was not detected by the tube test, and a significant difference was observed in the frequencies of the determined Le(a−b−) and Le(a−b+) phenotypes. Conclusion The phenotyping and genotyping of Lewis blood group system reveal a high rate of discordance in the frequencies of Lewis phenotypes among the healthy individuals.

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Section: Discussionmentioning

confidence: 99%

Divergence in phenotyping and genotyping analysis of the Lewis histo‐blood group system

Donta

Gorakshakar

Ghosh

2021

Transfusion Medicine

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“…[ 11 ] detected IgG anti-Le a in 12 of the 13 cord sera tested by kinetic enzyme-linked immunosorbent assay indicating that the IgG anti-Le a antibodies do cross the placenta though they do not cause HDNB because of the low levels of Lewis antigens on fetal red cells. However, the mild HDNB due to anti-Le a [ 12 ] and anti-Le b [ 13 14 ] has been documented in literature.…”

Section: Discussionmentioning

confidence: 99%

The prozone effect exerted by the complement-binding anti-Le^a on anti-D

Joshi¹,

Parekh²

2017

Asian J Transfus Sci

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BACKGROUND:Prozone phenomenon is seen with very high-titer antibodies in an immune serum.AIM:The prozone effect on anti-D by a low-titer anti-Lea was investigated associated with neonatal jaundice.MATERIALS AND METHODS:Standard methods were used in investigations.RESULTS:The child was born at full-term developed mild jaundice. With weak direct antiglobulin test+, her indirect serum bilirubin was progressed to 27.5 mg/dL in 48 h. Anti-D and anti-Lea were detected in the mother. Both these antibodies were detected in the child's serum though the eluate from red blood cells (RBCs) contained only anti-D. Mother's anti-D was masked by anti-Lea if the RBCs possessed both the antigens together. Anti-D was revealed only with D-positive RBCs lacking Lea or if the serum was modified by mixing with Lea+ saliva or was heated at 56°C or fortified with citrate solution.CONCLUSION:An anti-D showed prozone effect exerted by the complement-fixing anti-Lea in the test.

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