Screening for DEL phenotype in RhD negative Indians

J Clin Lab Anal. 2018 Mar;32(3):e22288. doi: 10.1002/jcla.22288. Epub 2017 Jun 23.

Abstract

Background: DEL phenotype represents a very weak form of D variant detected only by adsorption and elution technique. DEL phenotype individuals mistyped as RhD-negative can lead to alloimmunization after transfusion or pregnancy. Molecular techniques have now been used to identify DEL variants. They are commonly encountered in the East Asian population with RHD(K409K) being the most frequent allele. RHD(M295I) is the most common DEL allele in Caucasians. As there is a paucity of data on DEL phenotype in the Indian population, the study aims to screen RhD negative individuals for two most common DEL mutations.

Material and methods: EDTA blood was collected from 900 RhD negative individuals. Serological analysis included testing for the five major Rh antigens- C, c, D, E, and e by tube technique. Samples showing negative reaction for the presence of D antigen by Indirect Antiglobulin test were further tested for DEL phenotype by adsorption and elution technique. Molecular analysis involved DNA extraction and testing by PCR-SSP for RHD(K409K) and RHD(M295I) DEL alleles.

Results: Rh phenotyping showed 153 Rh negative individuals with r'r, ten with r''r and 737 with rr phenotype. All the samples tested negative for RhD antigen by adsorption and elution method. The two common DEL mutations RHD(K409K) and RHD(M295I) were also not detected in the study population.

Conclusion: The study population showed the absence of the two common DEL alleles, concluding the variant to be rare. A comprehensive study with a larger sample size to look for other DEL mutations should be performed.

Keywords: D variants; DEL phenotype; Indians; RhD negative; polymerase chain reaction using sequence specific primers.

MeSH terms

  • Alleles
  • Blood Grouping and Crossmatching / methods*
  • Humans
  • India / epidemiology
  • Molecular Typing / methods*
  • Phenotype
  • Rh-Hr Blood-Group System / genetics*
  • Sequence Deletion / genetics*

Substances

  • Rh-Hr Blood-Group System