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Case Reports
. 2022 Sep 22;38(3):77-81.
doi: 10.21307/immunohematology-2022-046. Print 2022 Sep 1.

Investigating anti-D in an individual with the weak D type 2 genotype

S Phou  1 , N Nguyen  2 , J Revilla  2 , K Rodberg  2 , D R Gibb  3 , S H Pepkowitz  3 , E B Klapper  3
Affiliations
Case Reports

Investigating anti-D in an individual with the weak D type 2 genotype

S Phou et al. Immunohematology. .

Abstract

Anti-D in individuals with a weak D phenotype is an unexpected finding that may require additional investigation to determine whether the anti-D is an autoantibody or alloantibody. Further investigation may also include assessment of the patient's RHD genotype and exclusion of anti-G. We present a case of an 84-year-old man with the weak D type 2 genotype who developed an unexpected anti-D along with anti-C. Individuals with the weak D type 2 genotype are thought not to be at risk for developing alloanti-D, although the distinction between alloanti-D and autoanti-D may be difficult to ascertain. Furthermore, investigations may affect transfusion recommendations. This patient was restricted to crossmatch-compatible, D-C- red blood cells even though the clinical significance of the anti-D was uncertain. This report is one of a few reported cases of an individual with the weak D type 2 genotype with demonstrable anti-D but without evidence for alloanti-D.

Keywords: alloanti-D; anti-D; anti-G; autoanti-D; weak D type 2.

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