Anti-LW masquerading as anti-D in a D+ patient
Document Type
Article
Department
Pathology and Laboratory Medicine
Abstract
LWa, LWab, LWb, and LWEM are the four main antigens of the Landsteiner-Weiner (LW) blood group system. LW expression may be weakened during pregnancy and immune dysregulation, with the subsequent appearance of anti-LW. Here, we describe a case of an elderly male patient in whom transfusion of red blood cells (RBCs) became challenging because of the presence of anti-LW. A 61-year-old male patient presented with shortness of breath and a hemoglobin level of 7.0 g/dL, requiring RBC transfusions. Serologic workup of his blood sample showed his RBCs to be group A, D+, but his serum was incompatible with several group A, D+ donor RBC units. Antibody screening showed preferential reactivity with D+ panel RBCs that was abolished when using 0.2 M dithiothreitol-treated RBCs. The patient's serum did not react with known RBCs of Rhnull and LW(a-) phenotypes but reacted strongly with D+ and D- cord RBCs. The patient's sample was genotyped as LW*A/A (c.299A), consistent with the LW(a+b-) phenotype. Subsequent bone marrow examination showed B-lymphoproliferative disorder. The patient required RBC transfusion support because of his underlying disease. Transfusion of group A, D- RBCs was uneventful. The expression of LW in this patient was possibly weakened by his underlying disease, leading to the development of an
Publication (Name of Journal)
Immunohematology
DOI
10.2478/immunohematology-2025-0004
Recommended Citation
Moiz, B.,
Hasan, M.,
Salman, M.,
Kumari, B.,
Black, E.,
Liew, Y. W.
(2025). Anti-LW masquerading as anti-D in a D+ patient. Immunohematology, 41(1), 11-16.
Available at:
https://ecommons.aku.edu/pakistan_fhs_mc_pathol_microbiol/1592
