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Ann Lab Med. Nov 2012; 32(6): 429–432.
Published online Oct 17, 2012. doi:  10.3343/alm.2012.32.6.429
PMCID: PMC3486938
Sensitization to Multiple Rh Antigens by Transfusion of Random Donor Platelet Concentrates in a -D- Phenotype Patient
Jae Won Yun, M.D.,1 Eun-Suk Kang, M.D.,1 Chang-Seok Ki, M.D.,1 Kwang Cheol Koh, M.D.,2 and Dae Won Kim, M.D.corresponding author1
1Department of Laboratory Medicine & Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
2Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
corresponding authorCorresponding author.
Corresponding author: Dae Won Kim. Department of Laboratory Medicine & Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Korea. Tel: +82-2-3410-2701, Fax: +82-2-3410-2719, dwsmc.kim/at/samsung.com
*Jae Won Yun and Eun-Suk Kang have contributed equally to this work as first author.
Received April 27, 2012; Revised August 10, 2012; Accepted September 24, 2012.
Abstract
The -D- phenotype is a rare Rh phenotype that strongly expresses D antigen without C, c, E, or e antigens. In -D- phenotype individuals, anti-Rh17 (Hro) is commonly found if there is a history of pregnancy or transfusion with red blood cells (RBCs) that express C, c, E, or e antigens. We report the first case of a -D- phenotype patient with multiple Rh antibodies including anti-Rh17 who had a history of two occasions of transfusion with eight random donor platelet concentrates two and six years ago. We found that a trivial amount of RBCs in the platelet components was able to trigger sensitization to RBC antigens, especially the highly immunogenic and clinically significant Rh antigens, including C, c, E, e or CcEe polypeptides. To avoid unnecessary sensitization and to minimize the risk of hemolytic transfusion reactions in patients with this rare Rh phenotype, a modified strategy for pretransfusion screenings needs to be discussed in the field of transfusion medicine.
Keywords: Rh-Hr blood group system, Rh isoimmunization, Platelet transfusion
Articles from Annals of Laboratory Medicine are provided here courtesy of
Korean Society for Laboratory Medicine