Clin Lab. 2024 Mar 1;70(3). doi: 10.7754/Clin.Lab.2023.230920.
Rh(D) phenotype in a sample from a 19-year-old female patient showed weak positivity (1+). A follow-up sample was requested to further define the Rh(D) phenotype, her Rh(D) phenotype was tested by using another reagent, Rh(D) phenotype still showed weak reactivity (1+), RhCcEe phenotype was Ccee.
Seven samples from the family members of the proposita were received. The RhDCcEe phenotypes were typed by the microcolumn gel card and the unexpected antibodies were assayed by indirect anti-human globulin test (IAT). Genomic DNA was extracted from the blood sample and the novel RHD1058G>C allele was detected through an established sequence-specific primer PCR (PCR-SSP), RHD exons 1 - 10 were sequenced afterward by exon-specific amplification. The distribution of RHD1058G>C allele and RHD weak positive phenotype were investigated in the pedigrees.
The unexpected antibodies all were negative in the family members. The novel RHD1058G>C allele was found in the proposita, her father, and grandfather. Five family members were detected serologically with the common Rh(D)-positive phenotypes either as homozygote of RHD/RHD or heterozygote of RHD/RHd. Two family members were detected as weak D phenotypes in accordance with the genotyping results by PCR-SSP, and both of them have a D1058Ce haplotype and a dce haplotype. One member, her father, was tested common Rh(D)-positive with D1058Ce haplotype and a Dce haplotype.
These data allow us to describe the characteristics of the weak D phenotype with a novel c.RHD-1058G>C allele, which may be partial D and increase the risk of RHD alloantibody. The novel RHD1058G>C allele was inherited in three generations in a family rather than spontaneous mutation in an individual.
从一名 19 岁女性患者的样本中检测到 Rh(D)表型呈弱阳性(1+)。为了进一步确定 Rh(D)表型,要求再次送检样本。结果使用另一种试剂检测到 Rh(D)表型仍呈弱阳性反应(1+),RhCcEe 表型为 Ccee。
收集了先证者的 7 名家族成员的样本。使用微柱凝胶卡对 RhDCcEe 表型进行分型,并通过间接抗人球蛋白试验(IAT)检测意外抗体。从血液样本中提取基因组 DNA,通过建立的序列特异性引物 PCR(PCR-SSP)检测新型 RHD1058G>C 等位基因,随后通过外显子特异性扩增对 RHD 外显子 1-10 进行测序。调查该家系中 RHD1058G>C 等位基因和 Rh(D)弱阳性表型的分布情况。
在家族成员中,所有意外抗体均为阴性。在先证者、其父亲和祖父中发现了新型 RHD1058G>C 等位基因。5 名家族成员被检测为常见 Rh(D)阳性表型,为 RHD/RHD 纯合子或 RHD/RHd 杂合子。根据 PCR-SSP 的基因分型结果,2 名家族成员被检测为弱 D 表型,均具有 D1058Ce 单倍型和 dce 单倍型。一名家族成员,其父亲,被检测为常见 Rh(D)阳性,具有 D1058Ce 单倍型和 Dce 单倍型。
这些数据使我们能够描述具有新型 c.RHD-1058G>C 等位基因的弱 D 表型的特征,该等位基因可能为部分 D,增加了 Rh(D)同种异体抗体的风险。新型 RHD1058G>C 等位基因在一个家族中三代遗传,而非个体自发突变。