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BB Other Blood Group Systems
BB Other Blood Group Systems
phenotypes antibodies
Major Blood Group Systems ABH NONE ABH, Le(a-b-) Anti-Lea &
a. Lewis lele Anti-Leb
b. I sese
c. P ABH ABH ABH, Le(a-b-) Anti-Lea &
d. MNSs lele Anti-Leb
e. Kell SeSe/Sese
f. Kidd ABH Lea ABH, Le(a+b-) Anti-Leb
g. Duffy Lele/Lele
h. Lutheran sese
ABH ABH ABH, Le(a-b+) NONE
MAJOR BLOOD GROUPS SYSTEMS Lele/Lele Lea
Chromosome Locus SeSe/Sese Leb
Lea Se Leb
1 Duffy
4 MNSs Leb associated with receptor of H. pylori
7 Kell
18 Kidd Lewis system (Phenotypes and Frequencies)
19 Lewis, Lutheran Phenotype White (%) Black (%)
(a+b-)
Le 22 23
22 P1 (a-b+)
Le 72 55
(a-b-)
Le 6 222
Basic terms to remember Cord blood and red cells from newborn infants
Clinical significance: antibodies that is associated phenotypen as Le(a-b-)
with decreased RBC survival
Transfusion reactions Lewis Antigens
HDN Soluble antigens produced by tissues and found
Not clinically significant: antibodies that do not in body fluids (plasma)
cause red cell destruction Adsorbed on the RBC
Cold reacting antibodies: agglutination best
observed at or below room temp.
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B. MNSs (002) SYSTEM Anti-M and anti-N antibodies
4 important antigens (more exist): Demonstrate dosage
M Anti-M and anti-N
N IgM (rarely IgG)
S Not clinically insignificant
s If IgG, could be implicated in HDN (RARE)
U (ALWAYS present when S & s are inherited; Will not react with enzyme treated cells
usually in Black population) Anti-Nf seen in renal patients, who are
M & N located on Glycophorin A dialyzed on equipment sterilized with
S & s and U located on Glycophorin B formaldehyde
Remember: Glycophorin is a protein that Anti-S, Anti-s Antibodies
carries many RBC antigens Clinically significant
IgG
MNSs System (Phenotype and Frequencies) Implicated with severe hemolytic transfusion
Phenotype Whites (%) Blacks (%) reaction with hemoglobinuria and HDN
M+N- 28 26 Anti-U Antibodies
M+N+ 50 44 Will react with S+ or s+ red cells
M-N+ 22 30 Usually occurs in S-s- cells
S+s- 11 3 Can only give U-negative blood units
S+s+ 44 28
Enhanced with enzyme treatment
S-s+ 45 69
S-s-U- 0 <1 MNSs Antibody Characteristics
M-N- : Resistant to P. Falciparum infection
MNSs Antigens
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P and Pk (Phenotype and Frequencies) D. I (207) SYSTEM
Phenotype White (%) Black (%)
P1 79 94 Ii Antigens
P2 21 6 These antigens may be I or i
They form on the precursor chain of RBC
null
P (P ) Rare Rare
1
Pk Very rare Very rare Newborns have i antigen
P2k Most rare Most rare
Adults have I antigen
i antigen (linear) converts to I (branched) as the
P Antigen child matures (precursor chain is more linear at
Similar to the ABO system birth) at about 18 months
The most common phenotypes are P1 and P2
Rare i Adult (I negative) Phenotype
P1 consists of P1 and P antigens
P2 consists of only P antigens Individuals who do not change their I status
Like the A2 subgroup, P2 groups can produce after birth, usually in HEMPAS (Hereditary
anti-P1 Erythroblastic Multinuclearity with Positive
75% of adults have P1 Acidifies Serum) patients.
Strength of the antigen decreases upon storage
Anti-I antibodies
Found in secretions like plasma and hydatid
cyst fluid Anti-I
Cyst of a dog tapeworm IgM
Benign Anti-I = naturally occurring and
P Antibodies usually reacts only at 4oC
Anti-P1 Pathologic Anti-I = broader thermal range
Naturally occurring IgM of activity, reacting up to 30-32oC. Attach in
Not clinically significant vivo and cause autoagglutination and
Strong Anti-P1 was observed in individuals vascular occlusion (Raynauds
infected with hydatid disease (E. granulosus) phenomenon) or intravascular hemolysis
Associated with fascioliasis, C. sinensis and Autoanti-I = associated as a cause of Cold
O. viverinni infections agglutinin disease (similar to PCH). May be
Anti-P secondary to Mycoplasma pneumonia
Produced in individuals with paroxysmal infections
cold hemoglobinuria (PCH) Anti-i
Baphasic hemolysin: In PCH IgG auto- Mostly, IgM and reacts best with saline-
anti-P attaches complement when cold suspended cells at 4oC
(fingers, toes). As the red cells circulate, Rare and is sometimes associated with
they begin to lyse (releasing Hgb) Infectious mononucleosis (Epstein-Barr
This PCH antibody is also called the Donath- Virus)
Landsteiner antibody IgG anti-i has also been described and has
Anti-PP1-Pk ( originally called Anti-Tja) been associated with HDN.
IgM (sometimes IgG)
Reacts over a wide thermal range
Associated with spontaneous abortion in
early pregnancy
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Cold Antibodies (IgM) implicated in severe hemolytic transfusion
Anti-Lea reactions and HDN
Anti-Leb McLeod phenotype, affecting only males is
Anti-I described as a rare phenotype with decreased
Anti-P1 Kell system antigen expression
Anti-M The McLeod syndrome includes the clinical
Anti-A, -B, -H manifestation of abnormal RBC morphology
Anti-N and compensated hemolytic anemia and
LIiPMABHN neurologic and muscular abnormalities
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Anti-Lub is an IgG antibody reactive at the
AHG phase; usually produced in response to
foreign RBC exposure during pregnancy or
transfusion
The Lu(a-b-) phenotype is race and may result
from three different genetic backgrounds
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