Chung Yoo Na, Chun Sejong, Phan Minh-Trang Thi, Nam Myung-Hyun, Choi Byung Min, Cho Duck, Choi Ji Seon
Department of Laboratory Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea.
Department of Laboratory Medicine, Chonnam National University Medical School & Hospital, Gwangju, Korea.
J Clin Lab Anal. 2018 Oct;32(8):e22580. doi: 10.1002/jcla.22580. Epub 2018 May 24.
Chimeras are composed of two or more different populations that originated from different zygotes. Blood chimerism arising from twins have been reported in the literature. Herein, we report the first blood group chimerism in triplets.
ABO blood grouping was carried out by manual tile methods (Merck Millipore, UK) and micro-column agglutination method (Bio-Rad, Cressier sur Morat, Switzerland). Flow cytometric analysis was performed with Anti-A-PE conjugated monoclonal antibodies (BD Biosciences, San Jose, CA, USA) and FACS Canto II (BD Biosciences). Molecular analysis was performed with allele-specific polymerase chain reaction (AS-PCR) and direct sequencing of the exons 6 and 7.
Mixed-field agglutination and weak agglutination against anti-A were revealed by ABO blood grouping. Flow cytometric analysis revealed the presence of both A cells and O cells. AS-PCR and sequencing showed two neonates with chimerism, with each neonate`s genotype being A102/O01/O02.
This is the first recorded case of blood chimera from a triplet in Korea. We recommend full investigation of blood group chimerism in neonates with ABO discrepancy, as blood chimerism is subject to certain caution in the clinical environment.
嵌合体由两个或更多源自不同受精卵的不同群体组成。文献中已报道过双胞胎产生的血液嵌合体。在此，我们报告三胞胎中的首例血型嵌合体。
采用手工玻片法（英国默克密理博公司）和微柱凝集法（瑞士莫拉特河畔克雷西耶的伯乐公司）进行ABO血型鉴定。使用抗A-PE偶联单克隆抗体（美国加利福尼亚州圣何塞的BD生物科学公司）和FACS Canto II流式细胞仪（BD生物科学公司）进行流式细胞术分析。采用等位基因特异性聚合酶链反应（AS-PCR）和外显子6和7的直接测序进行分子分析。
ABO血型鉴定显示对抗A呈混合视野凝集和弱凝集。流式细胞术分析显示存在A细胞和O细胞。AS-PCR和测序显示两名新生儿存在嵌合体，每名新生儿的基因型均为A102/O01/O02。
这是韩国首例记录在案的三胞胎血液嵌合体病例。我们建议对ABO血型不符的新生儿进行血型嵌合体的全面调查，因为在临床环境中血液嵌合体需要一定的谨慎对待。
