ANTI-D ANTIBODY PRODUCTION DUE TO TRANSFUSION OF DEL TYPE RBCS TO A D-NEGATIVE RECIPIENT: A CASE REPORT

Abstract

We experienced a case of a D-negative woman in whom anti-D antibody rose to a titer of 4,096 by Coombs' test, despite receiving a red blood cell transfusion from apparently D-negative donors. The RHD gene of the blood components that were transfused to her was analyzed by the PCR-SSP method, and one-point mutation G1227A was found in the gene from two blood components. This case was therefore thought to be exposed to D-antigen by blood transfusion of D_el type red blood cells, as a result of which she produced anti-D antibodies. However, no hemolytic episodes due to the anti-D antibody were found during her clinical course. It should be recognized that D_el type blood is occasionally included in D-negative blood, and that a D-negative recipient may produce anti-D antibody on blood transfusion of D_el type red blood cells.