Dentification and blood transfusion therapy of anti-C,e alloantibodies with anti-e,Jkb mimicking alloantibodies
Objective To investigate the differential diagnosis of 1 anti-C,e alloantibodies combined with anti-e,Jkb mimicking alloantibodies by absorption-elution test and titer integral method.Methods ABO,Rh and Kidd blood group an-tigens were identified by tube method.Two sets of panel cells were used for antibody screening and antibody specificity iden-tification by saline method,polyamine method and microcolumn gel method.The antibody was further confirmed by multiple absorption-elution tests and titer integral method.RHCE and JK gene were sequenced by multiple PCR.Results Serological gene sequencing analysis showed that the ABO blood group of the patient was A type with Rh subtype ccDEE and was posi-tive for direct antiglobulin test(DAT).Multiple absorption-elution tests and titer integral method demonstrated that the ser-um of the patient contained anti-C,e alloantibodies along with anti-e,Jkb mimicking autoantibodies and there were anti-e,Jkb mimicking autoantibodies on red blood cells(RBCs).According to gene sequencing analysis,there was G＞C at exon 676 of the RHCE gene,and the remaining exons were not mutated,suggesting that the RHCE phenotype was ccEE.The 838 G/A heterozygote of exon 9 in JK gene,Jk blood group phenotype was Jk(a+b+).Cross matched type A ccDEE and Jk(a+b-)RBCs were transfused,and no adverse reactions occurred.Conclusion Serology combined with molecular biology to i-dentify the phenotype of the patient's RBCs,absorption-elution test and titer integral method to identify the antibody of the patient's serum can detect the alloantibody type,thus providing strategies for targeted blood transfusion.
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