31 December 2024 (Tuesday) - Partial D

Our automated grouping machine didn’t like a particular sample and so I did a manual blood group. Look at that D rection. A D-group is positive, or it is not. And if the patient has had a blood transfusion from a donor of a differing D-group then there are two distinct populations of D-positive and D-negative cells.
That’s not what is happening here…
 
My initial reaction was that I’d stuffed the grouping up somehow and repeated it. And I got the same result…
 
A partial D reaction occurs when someone’s red cells have altered Rh(D) proteins (and therefore antigens) that react with some but not all anti-D typing reagents. And that looks like what has happened here.
There are many types of partial D, each with a unique genetic basis. Some people with partial D have weakly expressed D epitopes and are designated "partial weak D".
 
 
Interestingly these references hint that partial D happens in about 1% of the population… Having a degree in maths (which I have) and knowing our workload (which I do) I should be seeing cases like this many times a month.
But I don’t.
Presumably the anti-D we use picks up the more common variants and only has issues with the more obscure ones?
I am looking forward to see what NHSBT have to say about this one.

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