RHD*09.04 - RHD*DAR4
(ISBT table: RHD partial D v5.0)
This entry is an RHD allele.
DAR4, RHD(W16C,T201R,F223V), RHD(W16C,T201R,F223V,A273A), RHD*48C,602G,667G,819A, RHD*48C,602G,667G,819A (weak D type 4.1, DAR4), RHD*48G>C,602C>G,667T>G,819G>A, weak D type 4.1,
Molecular data
Phenotype
Main D phenotype: weak D (last update: Dec. 28, 2020)Reports by D phenotype
Other RH phenotypes: RH:-2, -3,
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
- 1 monoclonal IgG anti-D non-reactive with variant, 12 monoclonal IgG anti-D tested, sample used as control (Table S2)
- 0 monoclonal IgG anti-D non-reactive with variant, out of 22 monoclonal IgG tested (Table 2)
Antigen Density (Ag/RBC)
- 3811 Ag/RBC, derived from the results obtained with 59 of the 59 monoclonal IgG anti-D tested
- 1932 Ag/RBC, 1 sample used as control, with 12 anti-D (Table S1)
- range: 2424 - 3472, median: 2948 Ag/RBC, 2 samples, median (range) with 11 IgG anti-D
- 2842 Ag/RBC, 1 sample, 2 monoclonal anti-D
- 2904 Ag/RBC, 1 sample, 2 monoclonal anti-D
- 2958 Ag/RBC, 1 sample, 2 monoclonal anti-D
- 3451 Ag/RBC, 1 sample, 2 monoclonal anti-D
- 3892 Ag/RBC, 1 sample, 2 monoclonal anti-D
- 4496 Ag/RBC, 1 sample, 2 monoclonal anti-D
- 5343 Ag/RBC, 1 sample, 2 monoclonal anti-D
More phenotype data
Haplotype
Main CcEe phenotype association: ce (last update: Jan. 8, 2021)ce | Ce | cE | CE | |
---|---|---|---|---|
ce | 13 | 1 | 1 | 0 |
Ce | 0 | 0 | 0 | |
cE | 0 | 0 | ||
CE | 0 |
Reports by CcEe phenotype
- with ccEe 1 sample
- with Ccee 1 sample
- with ce 2 samples (2 samples used as controls, may have been included in other studies)
1 sample (haplotype given, not complete phenotype) (haplotype given, not complete phenotype)
7 samples
3 samples
0 samples (no sample count possible) (haplotype listed, not complete phenotype; presented as a general association) (Figure 2; presented as a general association, no sample count) (Figure 2; presented as a general association, no sample count)
Reports by allele association
Alloimmunization
Antibodies in carriers
Antibody specificity: D (RH1)
Summary: maybe allo-anti-D? (last update: Jan. 6, 2021)Detailed information
-
Noizat-Pirenne F et al. Transfus Clin Biol (2011)
- Ab specificity: D (RH1)
- Number (auto- or allo-): 1
- Number listed as allo-:
- Number listed as auto-:
- Number of carriers of the allele assessed:
- 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, probable
- Pregnancy history:
- Anti-D Ig history: ND
- Context: among 17 SCD patients with anti-D
- Hemolytic consequences:
- Comment:
-
Yu X et al. Transfusion (2006)
- Ab specificity: D (RH1)
- Number (auto- or allo-):
- 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: "D+ transfusion of RHef00313 and RHef00315 recipients must occur frequently, and anti-D immunizations in these phenotypes must be rare"
-
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"
Antibodies in D negative recipients
Alloimmunization in recipients: expected to be possible, see phenotype data
Reports
Summary: several descriptions, mainly in the German population, but also described in others (last update: Jan. 6, 2021)Detailed reports
- 1/161 random donors with weak D phenotype; DVI samples were excluded by serologic testing in the German population (Southwestern Germany), White (Table 6)
- 3/500 500 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)
- 2/167 (2 heterozygous with RHef00442) among 1702 samples tested for the combined presence of RHD c.602G and c.667G (700 Dutch White, 310 South African Black, 319 South African Asians, 197 Curacao Black, 176 Ethiopian Black) Ethiopian (Black)
- 7/16 514 RH:1,-2,-3,4,5 random donor samples were tested for D antigen density, 16 were in the lower range of antigen density and were genotyped German
- 1/360 donors with atypical D phenotype (discrepancies or reactivity weaker than 3+) Brazilian
- 1/351 out of 351 prenatal patients with discrepant D phenotyping results (population tested 608486 patients) Canada
- 1/100 donors with weak D phenotype Australia
- 1/64 among 175000 donors, 64 had weak D phenotype and underwent molecular identification in the Greek population
- 1/353 samples referred for discrepant or weak D typing in the USA population
- 1/16,253 (heterozygous with RHef00651) 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
- 1/10040 (CI: 1/3717 - 1/36822) estimated population frequency 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)
- 0.006 estimated allele frequency from a study of 1702 samples tested for the combined presence of RHD c.602G and c.667G (700 Dutch White, 310 South African Black, 319 South African Asians, 197 Curacao Black, 176 Ethiopian Black) Ethiopian (Black)
- 1/3463 (CI: 1/1761 - 1/7379) estimated allele frequency by testing random donor samples for D antigen density, those in the lower range of antigen density were genotyped German
- 0.00023 estimated prevalence in the German population
Structure mapping
Movement | Mouse Input | Touch Input | ||
---|---|---|---|---|
Rotation | Primary Mouse Button | Single touch | ||
Translation | Middle Mouse Button or Ctrl+Primary | Triple touch | ||
Zoom | Scroll Wheel or Second Mouse Button or Shift+Primary | Pinch (double touch) | ||
Slab | Ctrl+Second | Not Available |
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]
- Müller TH et al. PCR screening for common weak D types shows different distributions in three Central European populations. Transfusion, 2001. [Citation] [RHeference]
- Wagner FF et al. The DAU allele cluster of the RHD gene. Blood, 2002. [Citation] [RHeference]
- Chen Q et al. Random survey for RHD alleles among D+ European persons. Transfusion, 2005. [Citation] [RHeference]
- Körmöczi GF et al. Novel weak D types 31 and 32: adsorption-elution-supported D antigen analysis and comparison to prevalent weak D types. Transfusion, 2005. [Citation] [RHeference]
- Yu X et al. Outliers in RhD membrane integration are explained by variant RH haplotypes. Transfusion, 2006. [Citation] [RHeference]
- Grootkerk-Tax MG et al. RHD(T201R, F223V) cluster analysis in five different ethnic groups and serologic characterization of a new Ethiopian variant DARE, the DIII type 6, and the RHD(F223V). Transfusion, 2006. [Citation] [RHeference]
- Flegel WA et al. How I manage donors and patients with a weak D phenotype. Curr Opin Hematol, 2006. [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]
- Noizat-Pirenne F et al. Relevance of RH variants in transfusion of sickle cell patients. Transfus Clin Biol, 2011. [Citation] [RHeference]
- Arnoni CP et al. How do we identify RHD variants using a practical molecular approach? Transfusion, 2014. [Citation] [RHeference]
- 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]
- Clarke G et al. Resolving variable maternal D typing using serology and genotyping in selected prenatal patients. Transfusion, 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]
- Ouchari M et al. Serologic and molecular characterization of weak D type 29. Transfusion, 2017. [Citation] [RHeference]
- 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]
- S Vege et al. RHD Genotyping of Discrepant or Weak D Samples: Over a Year’s Experience. Transfusion, 2017. — Abstract — [RHeference]
- Flegel WA et al. A proposal for a rational transfusion strategy in patients of European and North African descent with weak D type 4.0 and 4.1 phenotypes. Blood Transfus, 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]
- Stef M et al. RH genotyping by nonspecific quantitative next-generation sequencing. Transfusion, 2020. [Citation] [RHeference]
- Floch A et al. Comment from Rheference Online ressource, 2020. — Online ressource — [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]
- Vege S et al. Impact of RHD genotyping on transfusion practice in Denmark and the United States and identification of novel RHD alleles. Transfusion, 2021. [Citation] [RHeference]
Last update: Jan. 8, 2021