A Korean family with RHD*DNT only detectable after anti-D alloimmunization

Am J Clin Pathol. 2024 Feb 1;161(2):111-114. doi: 10.1093/ajcp/aqad132.

Abstract

Objectives: Identification of DNT, a rare partial D, can be challenging, as it is difficult to distinguish from D+. This study aimed to identify DNT individuals by analyzing the DNT proband's family members, characterize DNT, and propose management strategies.

Methods: Family members of the first Korean DNT proband were recruited. RHD genotyping was conducted, and weak D tests were carried out using several anti-D reagents.

Results: Three DNT individuals were identified among 6 family members, including 1 with an anti-D alloantibody. As DNT red cells exhibited strong reactivity with all anti-D clones, DNT was serologically indistinguishable from D+. Moreover, unusual serologic findings in DNT individuals only became apparent after anti-D alloimmunization.

Conclusions: We recommend DNT individuals as candidates for Rh immune globulin prophylaxis during the perinatal period and transfusions with D- blood components. An anticipatory RHD genotyping is suggested for partial D family members to prevent potential partial D individuals from becoming alloimmunized.

Keywords: Rh immune globulin; alloimmunization; anti-D; partial D; rhesus blood group system.

MeSH terms

  • Female
  • Genotype
  • Humans
  • Pregnancy
  • Republic of Korea
  • Rh-Hr Blood-Group System* / genetics
  • Rho(D) Immune Globulin*

Substances

  • RHO(D) antibody
  • Rho(D) Immune Globulin
  • Rh-Hr Blood-Group System