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CHAPTER
S T U DY A I D
10
THE Rh BLOOD GROUP SYSTEM
TONY CASINA AND EVA D. QUINLEY
10-1. Complete the following table based on the reactions with the indicated Rh antisera.
AntiD
C
E
c
e
Wiener
ⴙ
ⴙ
0
0
ⴙ
R1R1 or R1r⬘
ⴙ
0
ⴙ
ⴙ
0
ⴙ
ⴙ
ⴙ
ⴙ
0
ⴙ
0
0
ⴙ
ⴙ
ⴙ
ⴙ
ⴙ
ⴙ
ⴙ
ⴙ
ⴙ
ⴙ
0
0
0
0
0
ⴙ
ⴙ
0
ⴙ
0
ⴙ
ⴙ
0
0
ⴙ
ⴙ
ⴙ
10-2. Of the phenotypes listed in the above table,
which is most common in the white population? _______________ Which is least common?
_______________
10-3. A patient has anti-f in her serum. Which of the
following donor units would you expect to be
crossmatch-compatible?
a. R1R2
c. RzR1
b. R1r
d. r'r"
10-4. Rank the following according to strength of
D-antigen expression based on reactions with
reagent anti-D (1 for strongest and 5 for weakest).
_____ R1R2
_____ Dc–/Dc–
_____ –D–/–D–
_____ R1R1
_____ R2R2
Fisher–Race
Rosenfield
10-5. Answer the following questions relating to the
results of testing this set of parents for the five
major Rh antigens.
Reactions with antiMother
Father
D
⫹
⫹
C
⫹
⫹
E
0
⫹
c
0
⫹
e
⫹
⫹
Rh control
NT
0
1) List all possible genotypes for the mother
and father.
2) Indicate the most probable genotype for each
assuming the individuals are Caucasian.
3) Using the most probable genotype for each as
listed in the previous question, list all possible
genotypes of offspring from this mating.
4) One of the offspring phenotypes is R2R2.
What are possible explanations?
5) Why was an Rh control run with the father’s
test?
NOTE
When appropriate, antiglobulin- or IgG-coated control cells have
been added and results are acceptable.
All readings are macroscopic only.
Standard abbreviations include NT, not tested; MF, mixed field;
H, hemolysis.
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UNIT 4 Red Blood Cell Groups and HLA
10-6. A sample from a maternity patient shows no reaction at immediate spin with reagent anti-D.
Records indicate this patient has been tested on
six previous occasions at your facility. On each
previous occasion, the patient’s cells reacted at at
least 3⫹ at immediate spin with reagent
anti-D. List as many explanations as possible for
this apparent discrepancy.
10-7. A patient has anti-D in his serum. The patient
was transfused with four units of Rh-positive
packed red blood cells 6 months ago after an
automobile accident. The patient’s red blood
cells are now weakly reacting with reagent antiD. The auto control and Rh control are negative.
Repeat testing with another manufacturer’s
anti-D shows identical results. Explain.