P, Rh And Rhag And Lutheran Bgs

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P1

Back 1

: variable expression between individuals and can be lost with in vitro storage

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Pk and P

Back 2

: high-frequency antigens on most donor RBCs (>99.9%)

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P antigen

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RBCs are particularly rich in _______________ (6% of the total RBC lipid)

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Null/Weak Phenotypes:P1 and P2 phenotypes (>99% of donors)

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- lack P antigen, p and Pk individual

- resistant to parvovirus B19

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Anti-P1

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- most common antibody observed

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Anti-P1

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detected in 1/3 to 2/3 of P2 donors

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Anti-P1

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-naturally occurring antibody (IgM isotype)

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Anti-P1

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- titers are often in patients with hydatid cyst disease or fascioliasis (liver fluke)

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Anti-P1

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not clinically significant and not a cause of HDFN

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Alloanti-PP1Pk

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- historically known as anti-Tja

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Alloanti-PP1Pk

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- naturally occurring and may be IgM only or IgM plus IgG (IgG3)

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Alloanti-PP1Pk

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potent hemolysins -

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alloanti-PP1Pk and alloanti-P

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=associated with HDFN and spontaneous abortion -

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Early and frequent plasmapheresis

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HDFn and spontaneous abortion Management:

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Alloanti-P

Back 15

- naturally occurring IgM alloantibody in the serum of Pk (and p) individuals -

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Alloanti-P

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potent hemolysin and can cause in vivo hemolysis -

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Alloanti-P

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cause of HDFN and is associated with spontaneous abortions

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Auto-Anti-P (Donath-Landsteiner)

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An autoantibody with anti-P specificity is seen in patients with paroxysmal cold hemoglobinuria (PCH)

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(PCH) Paroxysmal Cold Hemoglobinuria

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a clinical syndrome that may occur in children following viral infection -

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IgG

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In PCH, auto-anti-P is an

Hint 20

Poch ay Gay

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Biphasic hemolysin

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capable of binding RBCs at colder temp., followed by intravascular hemolysis at body temp (in vitro in the Donath-Landsteiner test)

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Pk antigen

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: marker of apoptosis in germinal center B cells, Burkitt lymphoma, and lymphoblastic leukemia

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LKE

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:marker of embryonic and mesenchymal stem cells and is implicated in adhesion, cell signaling, and metastasis in renal cell and breast carcinoma

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P blood group antigen

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: receptor for parvovirus B19

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P blood group antigen

Back 25

associated with multiple clinical sequelae, including aplastic crises

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Pk

Back 26

can bind human immunodeficiency virus (HIV) and may confer resistance to HIV infection

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P1 and Pk antigens:

Back 27

receptors for shiga toxins, produced by Shigella dysenteriae and enterohemorrhagic Escherichia coli (EHEC) strains

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P, Pk, LKE blood group antigens

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on uroepithelium are cell receptors for P-fimbriae( E. coli strains)

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Pk antigen

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also serves as a receptor for Streptococcus suis and Pseudomonas aeruginosa

Front 30

2molecules of Rh (RhD and RhCE) -2 molecules of RhAg

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RH AND RHAG BLOOD GROUP SYSTEMS composed of: -

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Weak D Antigen

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- characterized by weak or absent RBC agglutination by anti-D testing

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Partial D Antigen

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- RHD proteins with missing D epitopes

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Rh-Negative Phenotype

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- occurs in approx. 15% of white donors, almost always in association with a ce/ce or rr phenotype -

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1. anti-ce ( RH6)

2. anti-Ce (RH7)

3. anti-cE (RH27)

4. anti-CE (RH22)

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4 alloantibodies with “compound” Rh specificity :

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RH6

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Anti-ce

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RH7

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Anti-Ce

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RH27

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Anti-cE

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RH22

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Anti-CE

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Rh Antibodies- D

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most immunogenic Rh antigen followed by c, E,C, and e abs against Rh antigens -

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IgG isotype (IgG1 and IgG3)

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Most antibodies against Rh antigens are:

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AHG phase of testing

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Anti-Rh antibodies are reactive at 37° C and are usually detected in the -

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Rh Antibodies

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associated with HTRs

also a major cause of HDFN

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1. After an invasive procedure (i.e., amniocentesis)

2. Immediately after delivery to prevent alloimmunization

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All Rh-negative women should receive Rh immune globulin (IgG anti-D) prophylactically in mid pregnancy

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19 antigens

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LUTHERAN BLOOD GROUP SYSTEM (Lu)

Contains

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orthochromatic erythroblast stage

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Lutheran appears on RCs at the ____________________

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LUTHERAN BLOOD GROUP SYSTEM (Lu)

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Not clinically significant and rarely caused HDFN and HTRs