日本輸血学会雑誌
Online ISSN : 1883-8383
Print ISSN : 0546-1448
ISSN-L : 0546-1448
RhD陰性血の赤血球輸血にもかかわらず抗Dを産生したRhD陰性の1例
佐久間 志津枝伊藤 佳代鈴木 隆幸安田 広康大戸 斉室井 弥生平野 良紀金子 元久
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2005 年 51 巻 6 号 p. 585-588

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We experienced a case in which an anti-D antibody was developed after transfusion of RBCs from 19 apparently D-negative donors over a half-year period beginning in July 2000. The patient was 67-year-old. B-negative female with a history of sensitization by transfusion of D-positive RBCs. Antibody screening became positive and an anti-D was detected by indirect antiglobulin testing. However, no hemolytic episodes due to the anti-D were found in her clinical course. Specificity of the antibody was confirmed as an allo-anti-D by serological studies using differential absorption-elution or dithiothreitol-treated RBCs. We initially suspected the possibility of transfusion from D-positive or weak D donors and the Rh phenotypes of all 19 donors were back-checked. However, none was positive for D antigen by the indirect antiglobulin test and 5 donors included Ce haplotype. Genomic analysis to detect a Del, allele will demonstrate whether RBCs from a donor carrying a Del allele with Ce haplotype induced an allo-anti-D immune response.
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