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When checking transfusion histories for patients who have formed anti-D (or other blood group antibodies) it is important to ask the patient about other forms of blood exposure besides transfusion if the patient denies previous transfusion or pregnancies. In the past our laboratory identified patients who had formed anti-D in response to a bone transplant. We had another young women who was an intravenous cocaine user and who shared a needle with her boyfriend who was Rh positive (it was their practice to "flag" the hit by drawing back on the syringe to ensure the needle of the syringe was in a vein). We also identified patients who formed anti-D after receiving platelet and/or plasma transfusion. All of these sources of blood exposure are documented in the literature. We published an article about the IV drug abuser we found had formed anti-D (Chin-Yee I., Dietz G. and Marshall J. Alloimmunization and intravenous drug abuse. CMAJ 1989;141:1160-1161.) Glen