Literature DB >> 27504293

Enigmatic Weak D antigen: An Experience in a Tertiary Care Hospital of East Delhi.

Anshu Gupta1, Shabnam Mirza2, Sarbjeet Khurana3, Roopali Singh2, Sujata Chaturvedi4, Bharat Singh5.   

Abstract

INTRODUCTION: The Rh blood group system is one of the most polymorphic and immunogenic blood group systems in humans. The expression of Rh blood group antigen is complex, among that Rh-D antigen is the most important antigen because of its immunogenicity. It is easy to detect D antigen in most of the cases. Sometimes, variable expression of Rh-D antigen leads to presence of weak forms. Weak D reacts variably with anti D sera and poses a problem in blood banking. Molecular genetics of Rh-D revealed that weak D antigen is a Rh-D phenotype that possesses less numbers of complete D antigens on the surface of red blood cells. AIM: Present study was carried out to study weak D positivity in a tertiary neuropsychiatry hospital of East Delhi for compatibility testing in blood transfusion, to assess the implications and need of weak D testing and for population genetics study. This study tried to observe pattern of weak D antigen in four broadly classified religious communities also (Hindus, Muslims, Sikhs and Christians).
MATERIALS AND METHODS: This was a two years prospective hospital based study including patients as well as donors. All patients were tested for Rh-D factor by commercially available monoclonal anti-D sera. The individuals who were found negative with anti-D were further investigated for weak D antigen by using indirect antiglobulin test (IAT) by tube as well as gel card technique.
RESULTS: The results were compiled by using SPSS software version 21.0 and Microsoft excel. Among 3619 cases, 3502 (96.7%) were Rh-D factor positive while 117(3.2%) were Rh D factor negative. Among these 117 Rh-D negative cases, 9 (7.6% out of total Rh-D negatives and 0.25% out of total samples) were weak D positive and 108(2.98%) were actually D negative individuals after IAT. Weak D positivity showed a slight predominance in females (55.5%). As per broad religious communities, weak D antigen was found in Hindus only and not observed in Muslims, Sikhs and Christians. In weak D positive individuals, B phenotype (0.43%) was found to be most common followed by A (0.26%) and O (0.2%).
CONCLUSION: Considerably high frequency of weak D antigen was noticed in study samples of this hospital. With this data based information, it is felt worthwhile to perform weak D testing routinely of those individuals who are negative with saline anti-D to prevent possibility of haemolysis and for efficient blood transfusion practices by making compatible blood available.

Entities:  

Keywords:  Antigen; Antiglobulin test; Indirect; Neuropsychiatry

Year:  2016        PMID: 27504293      PMCID: PMC4963653          DOI: 10.7860/JCDR/2016/16278.7972

Source DB:  PubMed          Journal:  J Clin Diagn Res        ISSN: 0973-709X


  16 in total

1.  PCR screening for common weak D types shows different distributions in three Central European populations.

Authors:  T H Müller; F F Wagner; A Trockenbacher; N I Eicher; W A Flegel; D Schönitzer; F Schunter; C Gassner
Journal:  Transfusion       Date:  2001-01       Impact factor: 3.157

Review 2.  Molecular genetics and clinical applications for RH.

Authors:  Willy A Flegel
Journal:  Transfus Apher Sci       Date:  2011-01-28       Impact factor: 1.764

3.  Production of a blocking anti-D antibody by injection of Du red cells.

Authors:  M CARRIERE; J RUFFIE
Journal:  Br Med J       Date:  1951-12-29

4.  Anti-D alloimmunization by weak D type 1 red blood cells with a very low antigen density.

Authors:  M Mota; N L Fonseca; A Rodrigues; J M Kutner; L Castilho
Journal:  Vox Sang       Date:  2005-02       Impact factor: 2.144

5.  Weak D type 2 is the most prevalent weak D type in Portugal.

Authors:  F Araújo; M-J Rodrigues; F Monteiro; T Chabert; G Tavares; G Sousa; J Storry; J-E Guimarães
Journal:  Transfus Med       Date:  2006-02       Impact factor: 2.019

6.  Incidence of weak D in blood donors typed as D positive by the Olympus PK 7200.

Authors:  C M Jenkins; S T Johnson; D B Bellissimo; J L Gottschall
Journal:  Immunohematology       Date:  2005

7.  The Rh chromosome frequencies in England.

Authors:  R R RACE; A E MOURANT
Journal:  Blood       Date:  1948-06       Impact factor: 22.113

8.  Difficulties in Immunohaematology : The Weak D Antigen.

Authors:  H Kumar; D K Mishra; R S Sarkar; M Jaiprakash
Journal:  Med J Armed Forces India       Date:  2011-07-21

9.  A successful program of immunizing Rh-negative male volunteers for anti-D production using frozen/thawed blood.

Authors:  S J Urbaniak; A E Robertson
Journal:  Transfusion       Date:  1981 Jan-Feb       Impact factor: 3.157

10.  Prevalence of weak D in northern hilly areas of Uttarakhand, India.

Authors:  Nitin Agarwal; Iva Chandola; Amit Agarwal
Journal:  Asian J Transfus Sci       Date:  2013-01
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