Anti-D antibody in a D-positive patient: Autoantibody or development of alloantibody after platelet transfusion

Abstract

Rh D (D or RH 1) is next clinically important blood group after ABO blood group system. Although most people are either D+ or D−, there are a large number of individuals having different forms of D variants; weak D, partial D, or DEL phenotypes. We present a case report of a 32-year-old male with a history of cough and cold for 5 days with development of petechial rashes all over the body from day 1 and afebrile and marked thrombocytopenia. He was transfused with multiple platelet concentrates. Initially, there was an absence of irregular red cell antibodies, but after 72 h of transfusion, he developed autoanti-D antibody. An accurate D-antigen identification is important and essential for pretransfusion evaluation to prevent antibody formation, and a partial D variant might be suspected when typing for the D antigen showing weaker-than-normal reactions. This case emphasizes that some partial D variants are likely to be missed by routine serological tests.

Keywords

• anti-d antibody
• autoanti-d
• d positive (d+)
• platelet concentrates