Abstract
A 5-year-old male with sickle cell disease presented with pain, dark urine, and fatigue 10 days after a red blood cell (RBC) transfusion. Laboratory evaluation demonstrated severe anemia, blood type O+, and anti-D in the serum. Anti-D in a D+ patient led to RH genotyping, which revealed homozygosity for RHD*DAU4 that encodes partial D antigen. Anti-D in this patient whose RBCs exclusively express partial D caused a delayed hemolytic transfusion reaction after exposure to D+ RBCs. The finding of anti-D in a D+patient should be investigated by molecular methods to help distinguish an alloantibody from an autoantibody.
Publication types
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Case Reports
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Research Support, N.I.H., Extramural
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Research Support, Non-U.S. Gov't
MeSH terms
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Anemia, Sickle Cell / complications*
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Anemia, Sickle Cell / therapy
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Blood Group Incompatibility / diagnosis
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Blood Group Incompatibility / etiology*
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Child, Preschool
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Erythrocyte Transfusion / adverse effects*
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Humans
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Isoantibodies / analysis*
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Isoantibodies / immunology
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Male
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Pain / diagnosis
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Pain / etiology
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Prognosis
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Rh-Hr Blood-Group System / blood*
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Rh-Hr Blood-Group System / immunology
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Rho(D) Immune Globulin
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Transfusion Reaction / diagnosis
Substances
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Isoantibodies
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RHO(D) antibody
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Rh-Hr Blood-Group System
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Rho(D) Immune Globulin
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Rho(D) antigen