RH BLOOD GROUPS

50

A complex blood group systems composed of around _______ different antigenic specificities.

ISBT 004 RH BLOOD GROUP

2ND MOST IMPORTANT BLOOD GROUP SYSTEM IN TERMS OF TRANSFUSION

HEMOLYTIC DISEASE OF NEWBORN

The most important blood group system associated with ______

DELAYED AND EXTRAVASCULAR

THE TYPE OF HEMOLYSIS IS ______

1939

In ____, Levine and Stetson described a hemolytic transfusion reaction in an obstetrical patient and this was the first noted RH HTR case.

LANSTEINER AND WIENER

____ and ____ described an antibody made by guinea pigs and rabbits when they transfused with rhesus macaque monkey RBCs.

RHESUS MACAQUE MONKEY

ANTI-RH WAS NAMED AFTER

CHROMOSOME 1

Rh genes occupy at

2 GENES

Rh genes expression is controlled by

RHD

CONTROL D EXRESSION (NO d ALLELE)

RHCE

CONTROL C,c,E,e EXPRESSION

D

C

c

E

e

Rh 5 major antigens

‘d’

__ denotes the absence of the D antigen

D>c>E>C>e

Rh based on immunogenicity

IgG

Rh antibodies: ___ reacts at 37 C, implicated in HDFN/HTR

FISHER RACE (DCE) (UK THEORY)

Based on the theory that antigen of the systems were produced by three closely linked set of alleles, each gene was responsible for producing a product

ROSENFIELD (ALPHA NUMERIC)

Number is assigned to each antigen of the Rh system in order of its discover

- The nomenclature has no genetic basis

WIENER: Rh-Hr TERMINOLOGY (US THEORY)

_____ believed there was one gene responsible for defining Rh that produced an agglutinogen containing a series of blood factors

INTERNATIONAL SOCIETY OF BLOOD TRANSFUSION

Establish uniform nomenclature that is both eye readable and machine readable and is in keeping with the genetic basis of blood groups.

- Contains 6 digit (machine & eye readable)

SYSTEM

ISBT FIRST 3 DIGITS REPRESENTS THE

ANTIGENIC SPECIFICITY

ISBT LAST 3 DIGITS THE _______

Ce Ec

__ and __ and __ and __ are usually found together.

R1r

most common genotypes in whites (35%)

R’r

most common genotypes in blacks (42%)

R1>r>R2>R0

WHUTES RH GENETYPE SEQUENCE

R0>r>R1>R2

BLACK RH GENETYPE SEQUENCE

R1>R2>r and R0

ASIANS RH GENETYPE SEQUENCE

RH+ BUT RH- IN ROUTINE AND RH+ IN IAT

Rh (__) but Rh (__) in routine blood typing, (__) in IAT

1%

Approximately __ of D-positive individuals type as weak D

GENETIC WEAK D

weak expression of D antigen

- D antigens are complete but decreased in number

ERYTHROBLASTOSIS FETALIS

destruction of fetal RBCs resulting to anemia; erythroblasts are released into the circulation

HYDROPS FETALIS

a condition where severe anemia and

h y p o p r o t e i n e m i a l e a d t o t h e

development of high-output cardiac failure with generalized edema, effusions and ascites

HYPERBILIRUBINEMIA

buildup of bilirubin leads to jaundice and can cause deafness, mental retardation, or death.

KERNICTERUS

permanent damage to parts of the brain due to deposition of unconjugated or indirect bilirubin

PARALLEL TESTING

For early detection of HDN

Specimen: mothers serum collected @ 4 m o n t h s a n d 5 m o n t h s o f pregnancy(+) for HDN if there is 2 tubes rise in titer

CORDOCENTESIS

Percutaneous umbilical blood sampling

Fetal blood can be tested for Hb, Hct, bilirubin, blood type, DAT, and antigen phenotype and genotype

DIRECT ANTIGLOBULIN TEST

Most important test for diagnosing HDN

Detects coating of fetal RBCs in vivo