Is a panel cell listed as Ror considered to be single-dose or double dose for D antigen

[Dansket]

Cell #4 of ORTHO PANEL C lot# VRC203 is listed as Ror (D+C-c+E-e+). With all deference to Malcolm, do you consider Ror to have a single or double dose of the D antigen? I think D is present in a single dose on an Ror cell and that panel cell is "heterozygous" for the D antigen. Panel cells that are R1R1 or R2R2 are double dose or homozygous for the D antigen. Am I correct?

I don't think anti-D should be ruled out if cell# 4 is non-reactive but all other D positive cells are weakly-agglutinated (1+) and all D negative cells are not agglutinated.

Edited March 23, 2015 by Dansket

[Malcolm Needs ☆]

You are quite correct Dansket.  Even if the cell comes from a Black donor (and it probably does), and even if the donor is Fy(a-b-), it could still be R_oR_o or R_or (although the former is much more likely, the latter is by no means unknown - rare, but not unknown), or even a Partial RHD gene in trans with a "normal" RHD gene.

 

Without knowing all of this, I would not rule out anti-D either.

 

Mind you, as I've said many times before, genes can be homozygous, heterozygous and hemizygous - antigens cannot!

[Liz0316]

I agree with Malcolm. An Rho cell is considered to demonstrate a weak D reaction. I would not rule out anti D on the basis of a negative Rho cell.

Liz

[Malcolm Needs ☆]

I should add, of course, that the R1R1 red cell could be R1r', and the R2R2 red cell could be R2r", leaving aside other deletions, but it would be unlikely that you would have an R1r', an R2r", and an Ror, all in one panel!!!!!!!!!!!!

[rebeccarjthomas]

We had a patient referred to our Ref Lab that had an anti-D reactive strongly in Solid Phase with all D+ cells but Ro cells. Customer was certain there was an unusual aby here.

 

You are quite correct Dansket.  Even if the cell comes from a Black donor (and it probably does), and even if the donor is Fy(a-b-), it could still be R_oR_o or R_or (although the former is much more likely, the latter is by no means unknown - rare, but not unknown), or even a Partial RHD gene in trans with a "normal" RHD gene.

 

Without knowing all of this, I would not rule out anti-D either.

 

Mind you, as I've said many times before, genes can be homozygous, heterozygous and hemizygous - antigens cannot!

 

[Removed]

We had a patient referred to our Ref Lab that had an anti-D reactive strongly in Solid Phase with all D+ cells but Ro cells. Customer was certain there was an unusual aby here.

Edited June 3, 2015 by RollSlow10