A rare case of multiple alloantibody detection in a woman of childbearing age

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ABSTRACT

The Rhesus G antigen is expressed on C+ and D+ erythrocytes. As a consequence, anti-G antibodies can mimic the presence of anti-C plus anti-D specificity on Indirect Antiglobulin Test . It is not possible to discriminate between the three antibodies in routine testing because anti-G can only be highlighted with the adsorption-elution test. During pregnancy, it is important to identify anti-G antibodies because their presence has been associated with hemolytic disease of the fetus and newborn (HDFN). It is also of fundamental importance to identify the antibodies really present because when anti-D is absent rhesus prophylaxis must be administered. The present case report describes the findings in a 44-yearold woman, who was group A Rh negative (phenotype ccdee), weak D negative; antibodies screening by Indirect Antigloblin Test (IAT) was positive. Antibody identification by IAT revealed anti-C, anti-D and anti-Jka antibodies. Due to the concomitant presence of anti-C and anti-D, the test for anti-G antibody was carried out by using adsorption-elution test. The results showed that in the patient’s blood anti-G, anti-C, anti-D and anti-Jka antibodies were present. This case report illustrates the usefulness of using manual methods together with the automated methods in the Immunohematology Laboratory. In fact, the simultaneous presence of anti-C and anti-D must always induce to check for the presence of anti-G which can be identified only with adsorption-elution methods.

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