RHD*01W.3 - RHD*weak D type 3
(ISBT table: Weak D and Del v5.0)
This entry is an RHD allele.
RHD(S3C), RHD*8C>G, RHD*8G, RHD*8G (weak D type 3), weak D type 3,
Molecular data
Nucleotides:
8C>G;
Amino acids: S3C;
Hybrid allele encompassing at least one RHCE exon:
no
Comments on the molecular basis:
- intronic sequence established by long range PCR and NGS
- no other mutation in RHD, RHCE and RHAG by sequencing
- no additional mutation within RHD exons 1-10 and flanking intron regions
Extracellular position of one or more amino acid substitutions:
Splicing:
Unconventional prediction methods:
Phenotype
Main D phenotype: weak D (last update: Dec. 28, 2020)Reports by D phenotype
Other RH phenotypes: RH:-2, -3, -4,
Serology with monoclonal anti-D
- 0 monoclonal IgG anti-D non-reactive with variant, out of 60 monoclonal IgG anti 22 IgM anti-D tested
- 0 monoclonal IgG anti-D non-reactive with variant, out of 22 monoclonal IgG tested (Table 2)
- only a few anti-D tested
- tested with Diagast Dscreen kit
- tested with Diagast Dscreen kit and ID-Partial Rh D-Typing Set, results not detailed
- results are not detailed per Ab or per variant
- 0 monoclonal IgG anti-D non-reactive with variant, 1 sample tested with 2 panels of monoclonal anti-D (17 IgG, 4 IgM) (Table 3)
- weak reactions (+ to ++), with a panel of 10 monoclonal anti-D
Antigen Density (Ag/RBC)
- range: 1333 - 2650, median: 1948 Ag/RBC, with 6 IgG anti-D; 11 RH:1,2,-3,4,5 samples tested (table 3)
- Ag/RBC, epitope density profile with 59 monoclonal IgG anti-D (Figure 1)
- 1932 Ag/RBC, derived from the results obtained with 59 of the 59 monoclonal IgG anti-D tested
- range: 1503 - 1920, median: 1712 Ag/RBC, 2 samples, median (range) with 11 IgG anti-D
- 1876 Ag/RBC
- mean: 2477 Ag/RBC, 8 samples
- range: 554 - 1398, median 976 Ag/RBC, 2 R1r samples
- 1117 Ag/RBC, with 4 monoclonal anti-D; 1 RH:1,2,-3,4,5 sample (S2)
- median: 1505 Ag/RBC, 6 samples from Tyrol (Austria)
- median: 1732 Ag/RBC, 13 samples from Northern Germany
- median: 1768 Ag/RBC, 10 samples from Southwestern Germany
- mean: 2368 Ag/RBC, 9 samples; Ag density estimated from a measure with a single monoclonal IgG anti-D, compared to a RH:1,2,3,4,5 control sample with an antigen density assumed to be about 27.500 Ag/RBC
More phenotype data
Haplotype
Main CcEe phenotype association: Ce is the most frequent association (last update: Jan. 8, 2021)ce | Ce | cE | CE | |
---|---|---|---|---|
ce | 1 | 128 | 1 | 0 |
Ce | 86 | 0 | 0 | |
cE | 0 | 0 | ||
CE | 0 |
Reports by CcEe phenotype
- with ce 1 sample (Table S2) (haplotype given, not complete phenotype)
- with Ccee 1 sample (1 sample? used as control)
- with Ce 1 sample (heterozygous with RHef00313) (sample heterozygous with RHef00238)
- with ccEe 1 sample (typo between RHef00288 and RHef00301?)
2 samples (2 samples used as controls, may have been included in other studies)
5 samples
7 samples
24 samples
6 samples
68 samples
3 samples
12 samples
7 samples (haplotype given, not complete phenotype)
2 samples (haplotype given, not phenotype)
5 samples (haplotype given, not complete phenotype)
59 samples (haplotype given, not complete phenotype)
9 samples (haplotype given, not complete phenotype)
3 samples (haplotype given, not complete phenotype)
0 samples (no sample count, listed as a general association) (haplotype given, not complete phenotype; presented as a general association)
Reports by allele association
Alloimmunization
Antibodies in carriers
Antibody specificity: D (RH1)
Summary: not considered at risk for allo-anti-D despite exceptional anti-D descriptions (last update: Dec. 28, 2020)Detailed information
-
Denomme GA et al. Transfusion (2005)
- Ab specificity: D (RH1)
- Number (auto- or allo-): 0
- Number listed as allo-:
- Number listed as auto-:
- Number of carriers of the allele assessed:
- DAT:
- Autologuous control:
- Elution:
- Autoadsorption:
- Titer:
- Was anti-LW excluded?:
- Other antibodies detected:
- Cross matches (with Ab and RBCs from different partial types):
- Transfusion history:
- Pregnancy history:
- Anti-D Ig history:
- Context:
- Hemolytic consequences:
- Comment: lists exposures to standard D antigen and patient blood management for several carriers
-
Pham BN et al. Immunohematology (2013)
- Ab specificity: D (RH1)
- Number (auto- or allo-): 0
- Number listed as allo-:
- Number listed as auto-:
- Number of carriers of the allele assessed: 6
- DAT: NA
- Autologuous control: NA
- Elution: NA
- Autoadsorption: NA
- Titer: NA
- Was anti-LW excluded?: NA
- Other antibodies detected: NA
- Cross matches (with Ab and RBCs from different partial types): NA
- Transfusion history: ND
- Pregnancy history:
- Anti-D Ig history: ND
- Context: NA
- Hemolytic consequences: NA
- Comment:
-
L Castilho et al. Vox Sanguinis (2019)
- Ab specificity: D (RH1)
- Number (auto- or allo-):
- Number listed as allo-: 1
- Number listed as auto-:
- Number of carriers of the allele assessed:
- DAT: negative
- Autologuous control:
- Elution:
- Autoadsorption: "auto-anti-D (was) ruled out"
- Titer:
- Was anti-LW excluded?: "anti-LW (was) ruled out"
- Other antibodies detected: ND
- Cross matches (with Ab and RBCs from different partial types): ND
- Transfusion history: D+ units transfused, anti-D was detected 3 weeks after the last transfusion
- Pregnancy history:
- Anti-D Ig history: ND, probably none
- Context: 12 year-old Bzrazilian SCD patient
- Hemolytic consequences: Positive monocyte monolayer assay >5% suggests that the anti-D is clinically significant
- Comment: no other mutation by sequencing of RHD, RHCE and RHAG
-
Daniels G et al. Br J Haematol (2013)
(review)
- Ab specificity: D (RH1)
- Number (auto- or allo-): no new case detailed
- Number listed as allo-:
- Number listed as auto-: ND
- Number of carriers of the allele assessed: ND
- DAT: ND
- Autologuous control: ND
- Elution: ND
- Autoadsorption: ND
- Titer: ND
- Was anti-LW excluded?: ND
- Other antibodies detected: ND
- Cross matches (with Ab and RBCs from different partial types): ND
- Transfusion history: ND
- Pregnancy history:
- Anti-D Ig history: ND
- Context: ND
- Hemolytic consequences: ND
- Comment: "individuals with RHef00238, RHef00288, and RHef00301 make alloanti-D only extremely rarely, if at all"
-
Flegel WA et al. Curr Opin Hematol (2006)
- Ab specificity: D (RH1)
- Number (auto- or allo-): no new case detailed
- Number listed as allo-:
- Number listed as auto-:
- Number of carriers of the allele assessed:
- DAT: NA
- Autologuous control: NA
- Elution: NA
- Autoadsorption: NA
- Titer: NA
- Was anti-LW excluded?: NA
- Other antibodies detected: NA
- Cross matches (with Ab and RBCs from different partial types): NA
- Transfusion history: NA
- Pregnancy history:
- Anti-D Ig history: NA
- Context: NA
- Hemolytic consequences: NA
- Comment: "reports of the Rhesus Immunization Registery as of June 2006"
-
C Nixon et al. Transfusion (2016)
- Ab specificity: D (RH1)
- Number (auto- or allo-):
- Number listed as allo-: 1
- Number listed as auto-:
- Number of carriers of the allele assessed:
- DAT: negative
- Autologuous control: ND
- Elution: ND
- Autoadsorption: ND
- Titer: weakly reactive anti-D, detected with ficin-treated test-RBCs
- Was anti-LW excluded?: ND
- Other antibodies detected: ND
- Cross matches (with Ab and RBCs from different partial types): ND
- Transfusion history: yes, number and phenotype ND
- Pregnancy history:
- Anti-D Ig history: ND, probably none
- Context: 84 year-old female with digestive bleeding
- Hemolytic consequences: ND
- Comment: no additional mutation within RHD exons 1-10 and flanking intron regions; hemizygous
Antibodies in D negative recipients
Alloimmunization in recipients: expected to be possible, see phenotype data
Reports
Summary: common allele, mainly in individuals of Central European (Caucasian) descent or compatible with such descent (last update: Dec. 28, 2020)Detailed reports
- 7/161 random donors with weak D phenotype; DVI samples were excluded by serologic testing in the German population (Southwestern Germany), White (Table 5)
- 3/99 donors with weak D phenotype Australian
- 65/146 (+ 2 heterozygous with RHef00626 and RHef00238) donors with weak D phenotype White, in the Austrian (Tyrol) population
- 45/270 donors with weak D phenotype White, in the German (Northern Germany) population
- 3/168 among 168 samples referred for weak D phenotype and/or allo anti-D in D positive individuals, 137 were characterized in the study (70 by serology, 67 by molecular analysis, 31 could not be typed because serologic typing was inconclusive and molecular typing could not be performed) in the French population (Caucasian)
- 0/250 250 donors with RH:1,2,–3,4,5 phenotype among 1000 donors screened for RHD molecular variants by several PCR-SSP and exon 5 sequencing of all samples (500 R0r, 250 R1R, 250 R2r) in the German population (southwestern Germany)
- 1/55 55 discrepant or weak D phenotypes among 33864 multiethnic patients (of African, Asian, Indoasian and European extraction) in the Canadian (Toronto) population
- 14/99 individuals with weak D phenotype Portuguese
- 11/289 289 samples with ambiguous D phenotype (333 consecutive samples with ambiguous D phenotype studied but 44 were hybrid alleles, excluded from the study) in the French (Western France) population
- 19/201 (16 donors and 3 patients) among 201 samples with weak D expression, unclear D phenotype, or request for RHD typing within 44,743 donors and 8,604 patients tested in the Austrian population, Upper Austria
- 5/55162 among samples C or E positive and positive for "Du test" (55162 samples were typed; 314 were ddCcee, with 63 positive for "Du test" and 154 were ddccEe, with 30 positive for "Du test"; of the 93 "Du positive", 60 underwent molecular analysis) in the French population
- 9/101 donors with weak D phenotype Danish
- 4/141 donors and patients with ambiguous D phenotype in French population
- 2/26 donors with "weak D or questionnable D status" explored by NGS to compare with Sanger sequencing in the Austrian population, Upper Austria
- 77/167 discrepant D testing results (donors?) Croatian
- 4/43 (prevalence among weak D) or 4/5707 (phenotypic prevalence in population) 43 patients with weak D phenotype were genotyped in a cohort of 5707 patients from a private laboratory Argentinean
- 4/45 (prevalence among weak D phenotype) or 4/12672 (phenotypic prevalence in population) 45 patients wih weak D phenotype were genotyped in a cohort of 12672 patients from a public hospital Argentinean
- 3/16 among 2007 unrelated donors, 16 had weak D phenotype in the Brazilian population (Sao Paulo, mainly racially mixed non-white skin color individuals)
- 3/163 selected variants included for the development of a genotyping assay mainly in the Dutch population (samples may have been included in other studies)
- 35/430 (1 heterozygous) among samples with ambigous D phenotype in the French population (Table S1)
- 1/31200 consecutive donors with D negative phenotype tested for presence of RHD intron 4, exon 7 and/or exon 10 in the Polish population
- 6/748 among 748 individuals with D anomaly (weak or discrepant D phenotype or anti-D in individuals with D positive phenotype), 459 had D variants "that could be named weak D" (including alleles RHef00313, RHef00317 and RHef00318, as well as RHef00197 and RHef00283), 138 had partial D, 65 had no variant, 86 were not persued further (two variant alleles or incomplete or pending analysis) in the French population
- 59/360 donors with atypical D phenotype (discrepancies or reactivity weaker than 3+) Brazilian
- 6/58 (one heterozygous with RHef00238) within a donor population of 38836, 4272 initially typed D negative and 58 of these were found to be weak D with different reagents Albanian
-
0/2000 among 2000 random donors (1777 typed D positive), all donors were genotyped for 8G in the Tunisian population
(study may overlap with
24014941 ) - 13/627 weak D typing (95% from patients, 5% from donors; 21,2% were identified as RHef00442 or RHef00446 by authors, "mostly (…) inconclusive serology consequent to recent transfusion") in the Belgian (Flanders) population
-
0/45 among 763408 donors, after ruling out partial D phenotypes by using 5 monoclonal anti-D, 75 were considered weak D phenotype and 45 were genotyped Japanese
(some samples in common with
27183894 ) -
0/226 226 donors considered weak D phenotype, after ruling out partial D phenotypes by using 5 monoclonal anti-D Japanese
(1 sample in common with
26340140 ) - 5/400 among random blood and bone marrow donors genotyped for RHD in the Brazilian population (Parana state, Southern Brazil)
- 49/351 (+ 5 heterozygous: 2 with RHef00301 and RHef00333, 3 for RHef00238 and RHef00301) out of 351 prenatal patients with discrepant D phenotyping results (population tested 608486 patients) Canadian
- 8/100 donors with weak D phenotype Australian
- 2/104 (prevalence among weak D) or 2/21353 (phenotypic prevalence in population) 104 with weak D phenotype were genotyped in a cohort of 21353 pregnant women admixed Brazilian
- 32/32 samples with RHD c.8C>G mutation (typical of RHef00301), subtypes excluded in the French population (Western France)
- 0/223 donors with D negative phenotype initially, found to have D antigen expression (67 of the 223 samples of the cohort) or samples referred with discrepant or weak D typing, or discrepancies with previous typings, or anti-D in D positive individuals (156 of the 223 samples of the cohort) in the Indian population
- 1/26 26 samples with weak D phenotype, analyzed by NGS Caucasian, in the UK (Bristol) population
- 1/23 donors with weak D phenotype (among 4458 random donors, 4028 types D positive including 19 weak D phenotype, 420 typed D negative including 4 showed to be weak D by further serological testing; in total 23 donors had weak D phenotype) in the Maroccan population
- 50/85 donors with weak D phenotype Bosnia Herzegovinian
- 19/61 donors with weak D phenotype Serbian
- 1/92 donors with apparent D negative phenotype, with C and/or E Bosnia Herzegovinian
- 8/64 among 175000 donors, 64 had weak D phenotype and underwent molecular identification in the Greek population
- 26/231 231 donors with weak D phenotype in the Argentinean population (Northwestern Argentina)
- 40/273 donors with weak D phenotype in the Brazilian population
- 1/57 samples with ambiguous D phenotype among about 15,800 samples tested (22/5,800 donors and 35/10,000 patients had ambiguous D phenotype) presumed Caucasian, in the Danish population (91,4% Caucasian)
- 21/353 samples referred for discrepant or weak D typing mainly Whites, in the USA population
- 1/185 RH:–1,–4 or RH:–1,–5 recipients reported by a French lab
- 1 sample SCD patient Brazilian
- 6/94 donors with discreapancies in D typing Southeast Brazilian
- 1/16,253 samples of pregnant women with D negative of weak D (2+ or less), screened for fetal RHD in the Finnish population
- 1 hemizygote among 278 samples selected for the development of nonspecific quantitative next-generation sequencing. (non-random samples, may have been reported in other studies)
Allele or phenotype frequency
- 1/3759 estimated allele frequency in the German population (Southwestern Germany), White
- less than 1/371 estimated allele frequency by testing random donor samples for D antigen density, those in the lower range of antigen density were genotyped German
- 0.000219 estimated prevalence in the German population
- 1/31200(CI: 1/6577 - 1/608187) estimated allele frequency in individuals with D negative phenotype in the Polish population
- 1/12945 (CI: 1/35336 - 1/5948) estimated allele frequency Albanian
- 0.052 allele frequency in 58 patients with weak D phenotype Brazilian (mixed origin, mainly between African and European descent)
- 0.0047 allele frequency in 106 donors with weak D phenotype Brazilian (mixed origin, mainly between African and European descent)
- 0.006 calculated in 16,253 samples of pregnant women with D negative of weak D (2+ or less), screened for fetal RHD in the Finnish population
Structure mapping
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References
- International Society of Blood Transfusion et al. International Society of Blood Transfusion (ISBT) allele table Online ressource, 1935. — Online ressource — [RHeference]
- Wagner FF et al. Molecular basis of weak D phenotypes. Blood, 1999. [Citation] [RHeference]
- Wagner FF et al. Weak D alleles express distinct phenotypes. Blood, 2000. [Citation] [RHeference]
- Cowley NM et al. RHD gene mutations and the weak D phenotype: an Australian blood donor study. Vox Sang, 2000. [Citation] [RHeference]
- Müller TH et al. PCR screening for common weak D types shows different distributions in three Central European populations. Transfusion, 2001. [Citation] [RHeference]
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- Flegel WA et al. How I manage donors and patients with a weak D phenotype. Curr Opin Hematol, 2006. [Citation] [RHeference]
- Araújo F et al. Weak D type 2 is the most prevalent weak D type in Portugal. Transfus Med, 2006. [Citation] [RHeference]
- Yu X et al. Outliers in RhD membrane integration are explained by variant RH haplotypes. Transfusion, 2006. [Citation] [RHeference]
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- Noizat-Pirenne F et al. Weak D phenotypes and transfusion safety: where do we stand in daily practice? Transfusion, 2007. [Citation] [RHeference]
- Le Maréchal C et al. Identification of 12 novel RHD alleles in western France by denaturing high-performance liquid chromatography analysis. Transfusion, 2007. [Citation] [RHeference]
- Polin H et al. Effective molecular RHD typing strategy for blood donations. Transfusion, 2007. [Citation] [RHeference]
- Christiansen M et al. Correlation between serology and genetics of weak D types in Denmark. Transfusion, 2008. [Citation] [RHeference]
- Flegel WA et al. D variants at the RhD vestibule in the weak D type 4 and Eurasian D clusters. Transfusion, 2009. [Citation] [RHeference]
- Stabentheiner S et al. Overcoming methodical limits of standard RHD genotyping by next-generation sequencing. Vox Sang, 2011. [Citation] [RHeference]
- Silvy M et al. Weak D and DEL alleles detected by routine SNaPshot genotyping: identification of four novel RHD alleles. Transfusion, 2011. [Citation] [RHeference]
- Dogic V et al. Distribution of weak D types in the Croatian population. Transfus Med, 2011. [Citation] [RHeference]
- Brajovich ME et al. Comprehensive analysis of RHD alleles in Argentineans with variant D phenotypes. Transfusion, 2012. [Citation] [RHeference]
- Cruz BR et al. RHD alleles in Brazilian blood donors with weak D or D-negative phenotypes. Transfus Med, 2012. [Citation] [RHeference]
- Pham BN et al. Molecular analysis of patients with weak D and serologic analysis of those with anti-D (excluding type 1 and type 2). Immunohematology, 2013. [Citation] [RHeference]
- Fichou Y et al. Establishment of a medium-throughput approach for the genotyping of RHD variants and report of nine novel rare alleles. Transfusion, 2013. [Citation] [RHeference]
- Orzińska A et al. RHD variants in Polish blood donors routinely typed as D-. Transfusion, 2013. [Citation] [RHeference]
- Daniels G et al. Variants of RhD--current testing and clinical consequences. Br J Haematol, 2013. [Citation] [RHeference]
- Haer-Wigman L et al. RHD and RHCE variant and zygosity genotyping via multiplex ligation-dependent probe amplification. Transfusion, 2013. [Citation] [RHeference]
- Flegel WA et al. Phasing-in RHD genotyping. Arch Pathol Lab Med, 2014. [Citation] [RHeference]
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- Sandler SG et al. It's time to phase in RHD genotyping for patients with a serologic weak D phenotype. College of American Pathologists Transfusion Medicine Resource Committee Work Group. Transfusion, 2015. [Citation] [RHeference]
- Ouchari M et al. Weak D in the Tunisian population. Blood Transfus, 2015. [Citation] [RHeference]
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- Van Sandt VS et al. RHD variants in Flanders, Belgium. Transfusion, 2015. [Citation] [RHeference]
- Clarke G et al. Resolving variable maternal D typing using serology and genotyping in selected prenatal patients. Transfusion, 2016. [Citation] [RHeference]
- Isa K et al. Prevalence of RHD alleles in Japanese individuals with weak D phenotype: Identification of 20 new RHD alleles. Vox Sang, 2016. [Citation] [RHeference]
- Zacarias JM et al. Frequency of RHD variants in Brazilian blood donors from Parana State, Southern Brazil. Transfus Apher Sci, 2016. [Citation] [RHeference]
- Srivastava K et al. The DAU cluster: a comparative analysis of 18 RHD alleles, some forming partial D antigens. Transfusion, 2016. [Citation] [RHeference]
- Ogasawara K et al. Weak D alleles in Japanese: a c.960G>A silent mutation in exon 7 of the RHD gene that affects D expression. Vox Sang, 2016. [Citation] [RHeference]
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- McGowan EC et al. Diverse and novel RHD variants in Australian blood donors with a weak D phenotype: implication for transfusion management. Vox Sang, 2017. [Citation] [RHeference]
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- Fichou Y et al. Molecular basis of weak D expression in the Indian population and report of a novel, predominant variant RHD allele. Transfusion, 2018. [Citation] [RHeference]
- Bub CB et al. RHD alleles among pregnant women with serologic discrepant weak D phenotypes from a multiethnic population and risk of alloimmunization. J Clin Lab Anal, 2018. [Citation] [RHeference]
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- L Castilho et al. RHD*weak D type 3 and production of allo-anti-D in a patient with sickle cell disease (SCD) Vox Sanguinis, 2019. — Abstract — [RHeference]
- Raud L et al. Weak D type 1, 2 and 3 subtype alleles are rare in the Western French population. Transfus Med, 2019. [Citation] [RHeference]
- Koutsouri T et al. Frequency distribution of RHD alleles among Greek donors with weak D phenotypes demonstrates a distinct pattern in central European countries. Transfus Med, 2019. [Citation] [RHeference]
- El Housse H et al. Comprehensive phenotypic and molecular investigation of RhD and RhCE variants in Moroccan blood donors. Blood Transfus, 2019. [Citation] [RHeference]
- Arnoni CP et al. Correlation among automated scores of agglutination, antigen density by flow cytometry and genetics of D variants. Transfus Apher Sci, 2019. [Citation] [RHeference]
- Trucco Boggione C et al. Characterization of RHD locus polymorphism in D negative and D variant donors from Northwestern Argentina. Transfusion, 2019. [Citation] [RHeference]
- Guzijan G et al. Implementation of Molecular RHD Typing at Two Blood Transfusion Institutes from Southeastern Europe. Transfus Med Hemother, 2019. [Citation] [RHeference]
- Stef M et al. RH genotyping by nonspecific quantitative next-generation sequencing. Transfusion, 2020. [Citation] [RHeference]
- Tammi SM et al. Next-generation sequencing of 35 RHD variants in 16 253 serologically D- pregnant women in the Finnish population. Blood Adv, 2020. [Citation] [RHeference]
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Last update: Jan. 8, 2021