Variantes do antígeno RhD : estudo sorológico e molecular / RHD variants : sorological and molecular analysis

AUTOR(ES)
DATA DE PUBLICAÇÃO

2010

RESUMO

Rh discrepancies are becoming a problem during routine testing due to partial D or weak D phenotypes. Panels of monoclonal antibodies (MoAb) are being developed in order to identify D variants such as partial D and weak D when there are anomalous RhD typing results but molecular characterization offers a more specific grouping of weak and partial D. The weak D phenotype is caused by many different RHD alleles encoding aberrant RhD proteins, resulting in distinct serologic phenotypes and anti-D immunizations. We evaluated currently used serologic methods and reagents to detect and identify D variants and correlated the results with molecular analyses. A total of 335 blood samples from Brazilian blood donors and patients with discrepant results of D typing in routine were analyzed. In total, 215 (64.1%) weak D, 89 (26.5%) partial D, 3 (1%) DEL, 11 RhD-positive and 17 RhD-negative were identified. Among weak D samples, 76 weak D Type 1 (35.3%); 75 weak D Type 2 (34.9%); 13 weak D Type 3 (6.1%); 49 weak D Type 4 (22.8%) and 2 weak D Type 5 (0.9%) alleles were found. Among the partial D samples, 9 (10.1%) DAR, 25 (28.1%) DFR, 6 (6.7%) DBT, 1 (1.1%) DHMi, 1(1.1%) RoHAR, 26 (29.2%) DVI, 14 (15.8%) DVa, 5 DIVb (6.6%) and 2 (2.3%) DVII were observed. Two samples identified as DEL by adsorption/elution were characterized by molecular analyses as RHD(IVS5-38DEL4) and one sample as RHD(K409K). Our results showed that the use of different methods and anti-D reagents in the serologic routine reveal some D variants that can be further investigated. Molecular methods can help to differentiate between partial D and weak D and characterize the weak D types providing additional information of value in the RhD typing. This distinction is important for selection of blood products and to prevent anti-D hemolytic disease of the fetus and newborn

ASSUNTO(S)

antigenos imunohematologia genotipagem polimorfismo de um unico nucleotideo antigens immunohematology genotyping single nucletide polymorphism

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