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Alloanti‐c/ce in a c+ ceAR/Ce patient suggests that the rare RHCE*ceAR allele ( ceAR ) encodes a partial c antigen
Author(s) -
Peyrard Thierry,
Pham BachNga,
Poupel Sylvie,
MartinBlanc Stéphanie,
Auxerre Carine,
KapplerGratias Sandrine,
Bonin Philippe,
Rouger Philippe,
Le Pennec PierreYves
Publication year - 2009
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/j.1537-2995.2009.02308.x
Subject(s) - allele , medicine , microbiology and biotechnology , biology , genetics , gene
BACKGROUND: ceAR ( RHCE*ceAR ) is a rare RH allele encountered in people of African/Caribbean ancestry, known to encode a partial e antigen. The homozygous ceAR/ceAR genotype encodes the rare blood group Hr−. This study describes alloanti‐c/ce in a ceAR/Ce patient, suggesting that ceAR also encodes a partial c antigen. CASE REPORT: A 21‐year‐old patient suffering from intermediate β‐thalassemia, with transfusion history, was hospitalized for severe anemia. Blood samples were referred to the National Reference Laboratory for suspicion of a mixture of alloantibodies or an alloantibody to a high‐prevalence antigen. MATERIALS AND METHODS: Standard hemagglutination methods were performed to investigate the patient's RBCs and serum. A molecular analysis of RHD and RHCE was carried out by allele‐specific polymerase chain reaction and DNA sequencing. RESULTS: Blood type performed by the referring laboratory was B, D+C+E−c+e+, K−. Several antibodies were identified: anti‐c/ce, anti‐Fy b , anti‐Jk a , and anti‐S. Full serologic investigations showed that anti‐c/ce could be very likely considered as an alloantibody. The patient's genotype was ceAR/Ce . Anti‐c/ce reacted with ceAR/ceEK , ceEK/ceEK , and ceAR/ceBI but not with ceAR/ceAR , ceMO/ceMO , and ce s (340)/ce s (340) RBCs. CONCLUSION: This is the first case of alloanti‐c/ce related to ceAR , suggesting that this rare RHCE allele encodes a partial c antigen. The presence of the C antigen in the patient allowed for the partial expression of the c antigen encoded by ceAR . The c antigen encoded by ceAR appeared to be different than that encoded by ceEK and ceBI and may share common lacking epitopes with the c antigens encoded by ceMO and ce s (340) .