Other Blood Group Systems Flashcards
What other blood group systems exist?
- Duffy
- Kell
- Kidd
- P
- MNS
- Lewis
- Lutheran
- I
Duffy Blood Group
- Primary Ag: Duffy (Fy) gene is located on chr. 1 and express Fya and Fyb antigens co-dominantly.
- Ab reaction: IgG and rarely ‘c binding. Anti-Fya is more common than Anti-Fyb.
- HDFN: Yes
- HTR: Yes, severe extravascular
- Unique: Fy (a-b-) glycoprotein is a receptor to Plasmodium vivax (malaria)
Kidd Blood Group
- Primary Ag: Kidd (JK) gene is located on chr.18 and express JKa and JKb antigens co-dominantly.
- Ab reaction: IgM and IgG and ‘c binding. Anti-JKa is more common than Anti-JKb
- HDFN: Yes
- HTR: Yes, delayed extravascular
- Unique: Abs are unstable during storage and tests must be done on fresh blood
P Blood Group
-Primary Ag: P1 = P and Pk (globoside collection)
-Ab reaction: Anti-P is usually IgM and a naturally occurring cold agglutinin
Allo-anti-P1 is a rare Pk phenotype and naturally occurring
Auto-anti-P1 is the Donath-Landsteiner antibody
Anti-PP1Pk is usually IgM or IgG ‘c binding and naturally occurring
-HDFN:
-HTR:
-Unique: 1/100000 individuals have the p-phenotype (negative for P) and are resistant to the Parvo-B19 infection
Kell Blood Group
- Primary Ag: 25 Antigens, with 3 closely linked alleles on chr.7, K/k, Jsa/Jsb, Kpa/Kpb
- Ab reaction: IgM and IgG and ‘c binding. Most immunogenic after ABOD system
- HDFN: Yes
- HTR: Yes, sever extravascular
- Unique: Abs to Kell Ags is less commonly found making it difficult to find a negative donor.
Lutheran Blood Group
- Primary Ag: Commonly 24 Ag’s arising from BCAM variations. Lu (a-b-) is neg for Lu system. Lua and Lub are primary antigens.
- Ab reaction: IgM Anti-Lua and Anti-Lub, but can be IgG.
- HDFN: None-very mild
- HTR: None-very mild (weak expression of antigens in cord blood)
- Unique: Rarely problematic.
I Blood Group
- Primary Ag: I and i, quantities varies throughout different life stages, but there’s never a complete lack.
- Ab reaction: Auto-anti-I found in Anti-i adult phenotypes.
- HDFN: None
- HTR: None (newborns are I-negative)
- Unique: Patients recovering from infectious mononucleosis and alcoholic cirrhosis of the liver often have anti-i phenotype. False positive results due to auto-anti-I cold agglutinin in refrigerated samples.
MNS Blood Group
- Primary Ag: GYPA and GYPB are closely linked alleles on chr.4 and code for glycophorin A and glycophorin B (sialoglycoproteins of RBC membrane). M and N are alleles of GYPA and S and s are alleles of GYPB. U antigen is usually associated with the MNSs system and most individuals are U positive. U negative individuals are also S-s-.
- Ab reaction: M and N are usually IgM and rarely IgG. S and s are IgG ‘c binding.
- HDFN: Only when IgG
- HTR: Only when IgG
- Unique: Abs can be detected by enzyme treatment. Enzymes remove sialic acid layer of RBCs leaving no Ags left for Abs to react with and resulting in antibodies to go undetected.
Lewis Blood Group
- Primary Ag: Lea and Leb. Located on soluble glycosphingolipids found in plasma and saliva, and secondarily absorbed onto RBC membrane
- Ab reaction: Naturally occurring and usually IgM and ‘c binding Anti-Lea
- HDFN: None
- HTR: Very rare intravascular HTR, IgG Anti-Lea
- Unique: After transfusion, donor RBCs are converted to the Lewis phenotype of the recipient due to continuous exchange of glycosphingolipids between plasma and RBC membranes
Explain the Lewis Blood Group Inheritance and Biochemistry
-The Le gene is located on chromosome 19 and codes for a fucosyl-transferase 3, which acts on an adjacent sugar molecule on which the Se-gene is present.
- Genes that result in the formation of Le(a-b-) phenotype: Sese or SeSe or sese & lele
- Genes that result in the formation of Le(a+b-) phenotype: LeLe or Lele & sese
- Genes that result in the formation of Le(a-b+) phenotype: LeLe or Lele & SeSe or Sese
