Anti‐D investigations in individuals expressing weak D Type 1 or weak D Type 2: allo‐ or autoantibodies?
2011; Wiley; Volume: 51; Issue: 12 Linguagem: Inglês
10.1111/j.1537-2995.2011.03207.x
ISSN1537-2995
AutoresBach‐Nga Pham, Michèle Roussel, Thierry Peyrard, Marylise Beolet, Véronique Jan‐Lasserre, Dominique Gien, Maryline Ripaux, Sébastien Bourgouin, Sandrine Kappler‐Gratias, Philippe Rouger, Pierre‐Yves Le Pennec,
Tópico(s)Platelet Disorders and Treatments
ResumoWhether anti-D produced by individuals with a weak D phenotype are allo- or autoantibodies remains a matter of debate even though blood transfusion practice is impacted. The aim of our study was to determine the serologic features of anti-D in individuals expressing the most frequent weak D type in Caucasians that are weak D Type 1 or weak D Type 2, to assess whether anti-D were allo- or autoantibodies.Serologic D typing and molecular analysis enabled the including of 121 weak D Type 1 individuals and 99 weak D Type 2 individuals in our study. Serologic features of anti-D included autologous controls, direct antiglobulin test, elution, and titration of anti-D before and after adsorption of serum on autologous red blood cells (RBCs).Serologic D typing showed a variable reactivity of RBCs expressing weak D Type 1 or weak D Type 2 (4+ to 0). Anti-D was identified in six weak D Type 1 and six weak D Type 2 individuals, respectively. The serologic data were in favor of autoantibodies.A complete anti-D investigation in individuals with a D variant (weak D or partial D identified by molecular analysis) should be systematically performed before any valid conclusion on the nature of the antibody. Transfusing weak D Type 1 or weak D Type 2 patients with D+ RBC units should be recommended. Weak D Type 1 or weak D Type 2 pregnant women do not need anti-D immunoprophylaxis.
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