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Anti-Jamz

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    Anti-Jamz reacted to Malcolm Needs in DAR/Cdes question   
    I am a little confused by your question, in as much as, in one place you say that the patient has the Partial D Type DAR, but in another you say that the patient has the Dw antigen, sometimes known by its trivial name Weil, or more properly as Rh23, which is a low prevalence antigen associated with Partial DV Type 4.  I think you mean that your patient has the DAR D Type, and that the D antigen is typing weakly.  Am I correct in thinking this?  I hope so, otherwise it doesn't make sense (at least, to me).
    Turning to the CdeS type, there are several (at least 8) of these in terms of genetic background.  All have one thing in common, and that is a Leucine to Valine substitution at position 245 of the mature position, due to a point mutation in exon 5 of the RHCcEe gene.  Five of these also have the Tryptophan to Cysteine substitution at position 16, resulting in the expression of (normally) the C antigen, due to a point mutation in exon 1.  However, 74% of C-, c+ Black Americans with normal expression of c have Cysteine at position 16.
    The thing is though, that any C antigen that is expressed is weakened, and some anti-C reagents do not react with it.  On the other hand, because there are at least 4 amino acid residues that are involved in the expression of the C and/or c antigen (at positions 16, 60, 68 and 120), it is more than possible (in fact, probable) where mutations are present, that the c antigen is expressed at a normal strength, whilst the C antigen is also expressed in the weakened form.  Indeed, the C antigen itself is a Partial C antigen, and such an individual can produce a form of anti-C, rather in the same way that an individual with a Partial D can produce a form of anti-D.
    So, to cut a long story short, this is why the individual will express the c and e antigens in the cis position, even though they also express the C and e antigens (in a manner of speaking) in the cis position, and why the ce (compound) antigen can also be expressed.
  2. Like
    Anti-Jamz reacted to Emwilson7 in online group study for SBB exam   
    If anyone else would like a copy of the SBB review guide, just send me your email address.

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