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Adverse Occurrence type:
Alerting signals, symptoms, evidence of occurrence:
Blood samples from a female child of Turkish origin carrying a complete isolated CD59 deficiency were received first at the age of 2 years and occasionally thereafter until the age of 5. The first samples already contained an antibody against a high prevalence antigen with a titer of 4 using the IAT.
Demonstration of imputability or root cause:
The patient's plasma contained an alloantibody directed against the high prevalence red blood cell (RBC) antigen CD59. The antibody specificity was identified using soluble recombinant human CD59 protein, which blocked the reactivity of the patient's antibody and of monoclonal anti-CD59 but not of monoclonal anti-CD55. In addition, RBC alloantibodies such as anti-K, anti-C, anti-c, or anti-Fy(a) remained unaffected. Therefore, inhibition by recombinant CD59 is a useful diagnostic tool to detect alloantibodies in the presence of anti-CD59.
Suggest new keywords:
CD59, high prevalence antigen, high incidence antigen, red cell antigen, monoclonal antibodies, sequencing,
Anliker, M., von Zabern, I., Hochsmann, B., Kyrieleis, H., Dohna-Schwake, C., Flegel, W. A. and Schrezenmeier, H. (2014). A new blood group antigen is defined by anti-CD59, detected in a CD59-deficient patient. Transfusion 54(7):1817-1822.
Expert comments for publication:
Although CD59 is known as a RBC antigen defined by monoclonal antibodies, it so far has not been identified as a blood group antigen, since the description of a human alloantibody was missing. This is the first demonstration of a human anti-CD59 alloantibody, which defines CD59 as an RBC blood group antigen. CD59 represents a candidate for a new blood group system.