RHD*01W.5 - RHD*weak D type 5
(ISBT table: Weak D and Del v5.0)
This entry is an RHD allele.
RHD(A149D), RHD*446A, RHD*446A (weak D type 5), RHD*446C>A, weak D type 5,
Molecular data
Phenotype
Main D phenotype: weak or very weak D (last update: Dec. 28, 2020)Reports by D phenotype
Other RH phenotypes: RH:-2, -5,
Serology with monoclonal anti-D
Antigen Density (Ag/RBC)
- range: 218 - 386, median 316 Ag/RBC, with 6 IgG anti-D; 6 RH:1,-2,3,4,5 samples tested (table 3)
- 286 Ag/RBC, 1 sample used as control
- mean: 514 Ag/RBC, 3 samples
- 165 Ag/RBC, used as control, approximate number of D antigenic sites
- 296 Ag/RBC, derived from the results obtained with 57 of the 59 monoclonal IgG anti-D tested
More phenotype data
Haplotype
Main CcEe phenotype association: cE is the most frequent association (last update: Jan. 8, 2021)ce | Ce | cE | CE | |
---|---|---|---|---|
ce | 0 | 1 | 6 | 0 |
Ce | 0 | 1 | 0 | |
cE | 10 | 0 | ||
CE | 0 |
Reports by CcEe phenotype
- with Ccee 1 sample
- with cE 2 samples (haplotype given, not complete phenotype)
- with ccEe 1 sample (1 heterozygous sample, probably with RHef00442)
- with CcEe 1 sample
5 samples (haplotype geiven, not complete phenotype)
3 samples (haplotype given, not complete phenotype)
0 samples (haplotype listed, not complete phenotype; presented as a general association)
2 samples
3 samples
Reports by allele association
Alloimmunization
Antibodies in carriers
Antibody specificity: D (RH1)
Summary: no published cases (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: 1
- 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:
-
Flegel WA et al. Curr Opin Hematol (2006)
(some samples overlap with other reports)
- Ab specificity: D (RH1)
- Number (auto- or allo-):
- Number listed as allo-:
- Number listed as auto-: 1
- Number of carriers of the allele assessed: 1
- 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, probably none
- Context: ND
- Hemolytic consequences: ND
- Comment: "reports of the Rhesus Immunization Registery as of June 2006"
Wagner FF et al. Transfus Med Hemother (2014)
Antibodies in D negative recipients
Alloimmunization in recipients: expected to be possible, see detailed reports and phenotype data
Reports
Summary: frequent descriptions, mainly described in predominantly Caucasian populations (last update: Dec. 28, 2020)Detailed reports
- 2/161 random donors with weak D phenotype; DVI samples were excluded by serologic testing in the German population (Southwestern Germany), White (Table 6)
- 4/146 donors with weak D phenotype White, in the Austrian (Tyrol) population
- 0/270 donors with weak D phenotype White, in the German (Northern Germany) population
- 2/738 samples with D negative, but C and/or E positive phenotype, screened for RHD specific sequences (in the 5'UTR region, exon 3 and exon 10) in the Austrian (state of Tyrol) population
- 0/104 samples with D negative, but C and/or E positive phenotype, screened for RHD specific sequences (in the 5'UTR region, exon 3 and exon 10) in the Swiss (Bern and the canton of Bern) population
- 0/400 samples with D negative, but C and/or E positive phenotype, screened for RHD specific sequences (in the 5'UTR region, exon 3 and exon 10) in the German (states of Lower Saxony, Saxony- Anhalt, Thuringia, Oldenburg, and Bremen) population
- 0/71 samples with D negative, but C and/or E positive phenotype, screened for RHD specific sequences (in the 5'UTR region, exon 3 and exon 10) in the Russian (Kirov Oblast) population
- 0/333 samples with D negative, but C and/or E positive phenotype, screened for RHD specific sequences (in the 5'UTR region, exon 3 and exon 10) in the Slovenian population
- 0/54 samples with D negative, but C and/or E positive phenotype, screened for RHD specific sequences (in the 5'UTR region, exon 3 and exon 10) in the German (city of Braunschweig and eastern parts of Lower Saxony) population
- 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
- 12/23 121022 donors tested: 201 had weak D phenotype and, among those, 23 very weak D phenotype German
- 4/289 289 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
- 1/45 45 samples referred for D typing discrepancies in the USA population (Table 2)
- 1/101 donors with weak D phenotype Danish
- 1/86 donors with D negative phenotype Uigur Chinese
- 1/23330 donor samples with D negative phenotype tested for RHD exons 4, 7 and 10 (94 were PCR positive, 74 weak D or DEL in subsequent serologic analysis) in the Austrian population, Upper Austria
- 3/141 donors and patients with ambiguous D phenotype in French population
- 3/101 among 2450 donors with D negative phenotype tested for RHD specific polymorphisms (101 were positive for the polymorphisms) Brazilian (Southeast and Northeast Brazil)
- 4/163 selected variants included for the development of a genotyping assay mainly in the Dutch population (samples may have been included in other studies)
- 4/430 among samples with ambigous D phenotype in the French population (Table S1)
- 1/748 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
-
1/2000 (heterozygous) random donors (1777 with D positive phenotype), all donors genotyped for RHD c.885T in the Tunisian population
(study may overlap with
24014941 ) - 3/627 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
- 2/37782 270 women with variant alleles among 37782 women with D negative phenotype, tested by quantitative fetal RHD genotyping designed to detect RHD exons 5 and 7 in the Dutch population
- 0/400 among random blood and bone marrow donors genotyped for RHD in the Brazilian population (Parana state, Southern Brazil)
- 1/351 (+ 2 heterozygous for RHef00301 and RHef00333) out of 351 prenatal patients with discrepant D phenotyping results (population tested 608486 patients) Canada
- 1/100 donors with weak D phenotype Australia
- 3/64 among 175000 donors, 64 had weak D phenotype and underwent molecular identification in the Greek population
- 1/231 231 donors with weak D phenotype in the Argentinean population (Northwestern Argentina)
- 2/57 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)
- 1/185 RH:–1,–4 or RH:–1,–5 recipients reported by a French lab
- 1/94 donors with discreapancies in D typing Southeast Brazil
- 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
- 1/23330 (CI: 1/4926 - 1/500000) estimated allele frequency in individuals with D negative phenotype in the Austrian population, Upper Austria
- 0.0047 allele frequency in 106 donors with weak D phenotype Brazilian (mixed origin, mainly between African and European descent)
- 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
- 1/23256 estimated allele frequency in the German population (Southwestern Germany), White
- 3.5e-05 estimated prevalence in the German 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]
- Flegel WA et al. Primary anti-D immunization by weak D type 2 RBCs. Transfusion, 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]
- Gassner C et al. Presence of RHD in serologically D-, C/E+ individuals: a European multicenter study. Transfusion, 2005. [Citation] [RHeference]
- Chen Q et al. Random survey for RHD alleles among D+ European persons. Transfusion, 2005. [Citation] [RHeference]
- Doescher A et al. Weak D type 1.1 exemplifies another complexity in weak D genotyping. Transfusion, 2005. [Citation] [RHeference]
- Denomme GA et al. Partial D, weak D types, and novel RHD alleles among 33,864 multiethnic patients: implications for anti-D alloimmunization and prevention. Transfusion, 2005. [Citation] [RHeference]
- Flegel WA et al. How I manage donors and patients with a weak D phenotype. Curr Opin Hematol, 2006. [Citation] [RHeference]
- Yu X et al. Outliers in RhD membrane integration are explained by variant RH haplotypes. Transfusion, 2006. [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]
- Westhoff CM et al. Rh complexities: serology and DNA genotyping. Transfusion, 2007. [Citation] [RHeference]
- Christiansen M et al. Correlation between serology and genetics of weak D types in Denmark. Transfusion, 2008. [Citation] [RHeference]
- Li Q et al. Molecular basis of D variants between Uigur and Han blood donors in Xinjiang. Transfus Med, 2008. [Citation] [RHeference]
- Polin H et al. Identification of RHD alleles with the potential of anti-D immunization among seemingly D- blood donors in Upper Austria. Transfusion, 2009. [Citation] [RHeference]
- Krog GR et al. Is current serologic RhD typing of blood donors sufficient for avoiding immunization of recipients? Transfusion, 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]
- Mota M et al. RHD allelic identification among D-Brazilian blood donors as a routine test using pools of DNA. J Clin Lab Anal, 2012. [Citation] [RHeference]
- Silvy M et al. Characterization of novel RHD alleles: relationship between phenotype, genotype, and trimeric architecture. Transfusion, 2012. [Citation] [RHeference]
- Rizzo C et al. Weak D and partial D: our experience in daily activity. Blood Transfus, 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]
- Haer-Wigman L et al. RHD and RHCE variant and zygosity genotyping via multiplex ligation-dependent probe amplification. Transfusion, 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]
- Wagner FF et al. The Rhesus Site. Transfus Med Hemother, 2014. [Citation] [RHeference]
- Van Sandt VS et al. RHD variants in Flanders, Belgium. Transfusion, 2015. [Citation] [RHeference]
- Ouchari M et al. Weak D in the Tunisian population. Blood Transfus, 2015. [Citation] [RHeference]
- A C Gaspardi et al. RHD variants in blood donors from Southeast Brazil. Transfusion, 2015. — Abstract — [RHeference]
- Stegmann TC et al. Frequency and characterization of known and novel RHD variant alleles in 37 782 Dutch D-negative pregnant women. Br J Haematol, 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]
- Clarke G et al. Resolving variable maternal D typing using serology and genotyping in selected prenatal patients. Transfusion, 2016. [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]
- Dezan MR et al. RHD and RHCE genotyping by next-generation sequencing is an effective strategy to identify molecular variants within sickle cell disease patients. Blood Cells Mol Dis, 2017. [Citation] [RHeference]
- Jérôme Babinet et al. Erratum à l’article : « Résumés des Posters » [Transfus. Clin. Biol. 24 (2017) 3S] Transfusion Clinique et Biologique, 2018. — Abstract — [RHeference]
- Dezan MR et al. High frequency of variant RHD genotypes among donors and patients of mixed origin with serologic weak-D phenotype. J Clin Lab Anal, 2018. [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]
- Trucco Boggione C et al. Characterization of RHD locus polymorphism in D negative and D variant donors from Northwestern Argentina. Transfusion, 2019. [Citation] [RHeference]
- Floch A et al. Comment from Rheference Online ressource, 2020. — Online ressource — [RHeference]
- Stef M et al. RH genotyping by nonspecific quantitative next-generation sequencing. Transfusion, 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