Background and Objectives: Anti-DW is a rare specificity that detects an antigen on DVa red blood cells (RBCs). Some anti-DW contain an inseparable component that cross-reacts weakly with RBCs expressing the low-incidence Rh antigen Rh32. RH32 is expressed by RBCs with either the R=Nor the DBT phenotype. Case Report: We describe here an antibody found in the serum of 2 patients that reacts equally well with RBCs possessing either DVa, R=N, or DBT phenotypes. The reactivity for DW and Rh32 antigens could not be separated by adsorption onto and elution from DW+Rh32– or from DW–Rh32+ RBCs. Conclusions: We suggest that amino acids encoded by nucleotides at the junction of exon 4 of RHD to exon 5 of RHCE may induce a conformation that is recognized by these equally reactive inseparable antibodies. Until such time that the epitope recognized by these antibodies is defined, we recommend use of the descriptive name anti-DW/Rh32.

1.
Tippett P, Lomas-Francis C, Wallace M: The Rh antigen D: Partial D antigens and associated low-incidence antigens. Vox Sang 1996;70:123–131.
2.
Wallace M, Lomas-Francis C, Beckers E, Bruce M, Campbell G, Chatfield S, Nagao N, Okubo Y, Opalka A, Overbeeke M, Scott M, Voak D.DBT: A partial D phenotype associated with the low incidence antigen Rh32. Transfus Med 1997;7:233–238.
3.
Issitt PD: Serology and Genetics of the Rhesus Blood Group System. Cincinnati, Montgomery Scientific Publications, 1979, pp 107–115.
4.
Tippett P: A speculative model for the Rh blood groups. Ann Hum Genet 1986;50:241–247.
5.
Tippett P: Rh blood group system: The D antigen, high- and low-frequency Rh antigens; in Vengelen-Tyler V, Pierce SR (eds): Blood Group Systems: Rh. Arlington, American Association of Blood Banks, 1987, pp 25–53.
6.
Chown B, Lewis M, Kaita H: A new Rh antigen and antibody. Transfusion 1962;2:150–154.
7.
Race RR, Sanger R: Blood Groups in Man, ed 6. Oxford, Blackwell Scientific Publications, 1975, p 638.
8.
Sabo B, McCreary J, Cupp D, Silberman W: The second example of anti-DW tested in parallel with the original serum, Bill (abstract). International Congress ISH-ISBT, 1982, p 233.
9.
George S, Gidden M, LaNoir D: A population survey and family study using anti-DW discovered in a case of hemolytic disease of the newborn. South Central Association of Blood Banks, Abstracts of Volunteer Papers, 23rd Annual Meeting, 1981.
10.
Spruell P, Lacey P, Bradford MF, Moulds M, Duran-Suarez JR, Copeland SA, Henry J, George SL: Incidence of hemolytic disease of the newborn due to anti-DW (abstract). Transfusion 1997;37(suppl):43S.
11.
Rouillac C, Colin Y, Hughes-Jones NC, Beolet M, D’Ambrosio A-M, Cartron J-P, Le Van Kim C: Transcript analysis of D category phenotypes predicts hybrid Rh D-CE-D proteins associated with alteration of D epitopes. Blood 1995;85:2937–2944.
12.
Rouillac C, Gane P, Cartron J, Le Pennec PY, Cartron JP, Colin Y: Molecular basis of the altered antigenic expression of RhD in weak D (Du) and RhC/e in RN phenotypes. Blood 1996;87:4853–4861.
13.
Beckers EAM, Faas BHW, Simsek S, Overbeeke MAM, Van Rhenen DJ, Wallace M, Von dem Borne AEGK, van der Schoot CE: The genetic basis of a new partial D antigen: DDBT. Br J Haematol 1996;93:720–727.
14.
Huang C-H: Molecular insights into the Rh protein family and associated antigens. Curr Opin Hematol 1997;4:94–103.
15.
Avent ND, Liu W, Jones JW, Scott ML, Voak D, Pisacka M, Watt J, Fletcher A: Molecular analysis of Rh transcripts and polypeptides from individuals expressing the DVI variant phenotype: An RHD gene deletion event does not generate all DVIccEe phenotypes. Blood 1997;89:1779–1786.
16.
Huang C-H: Human DVI category erythrocytes: Correlation of the phenotype with a novel hybrid RhD-CE-D gene but not an internally deleted RhD gene. Blood 1997;89:1834–1835.
17.
Faas BHW, Beckers EAM, Wildoer P, Ligthart PC, Overbeeke MAM, Zondervan HA, Von dem Borne AEKG, van der Schoot CE: Molecular background of VS and weak C expression in blacks. Transfusion 1997;37:38–44.
18.
Steers F, Wallace M, Johnson P, Carritt B, Daniels G: Denaturing gradient gel electrophoresis. A novel method for determining Rh phenotype from genomic DNA. Br J Haematol 1996;94:417–421.
1998
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.