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LETTER TO EDITOR
Year : 2021  |  Volume : 6  |  Issue : 1  |  Page : 112-113

Evidence of naturally occurring anti-Jkb in blood donor: A rare scenario


Department of Transfusion Medicine, Saveetha Medical College and Hospitals, Chennai, Tamil Nadu, India

Date of Submission24-Mar-2021
Date of Decision10-Apr-2021
Date of Acceptance04-May-2021
Date of Web Publication29-May-2021

Correspondence Address:
Dr. Suresh Kumar
Department of Transfusion Medicine, Saveetha Medical College and Hospitals, Chennai, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/gjtm.gjtm_24_21

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How to cite this article:
Kumar S, Annadurai H, Nadesan H, Panicker V. Evidence of naturally occurring anti-Jkb in blood donor: A rare scenario. Glob J Transfus Med 2021;6:112-3

How to cite this URL:
Kumar S, Annadurai H, Nadesan H, Panicker V. Evidence of naturally occurring anti-Jkb in blood donor: A rare scenario. Glob J Transfus Med [serial online] 2021 [cited 2021 Dec 7];6:112-3. Available from: https://www.gjtmonline.com/text.asp?2021/6/1/112/317128



Sir,

Naturally occurring antibodies are those which develop spontaneously without any sensitization events like transfusion and pregnancy. They are mainly developed due to unknown immune response against common environmental antigens such as pollens and bacterial cell membranes which share the common antigenic characteristics of human blood groups. These groups of antibodies have a broad spectrum of reactivity. Commonly, naturally occurring antibodies are ABO, P, Lewis, MN, Hh, and Ii blood group systems.[1] The prevalence of anti-Kidd antibodies in Indian population is 5.9%.[2] Among them, anti-Jkb is rare when compared to anti-Jka. One such rare scenario of naturally occurring anti-Jkb is described below.

A 25-year-old female came for voluntary blood donation at our blood center. After fulfilling the criteria for blood donation, she donated blood. There was no blood grouping discrepancy. Blood group was found to be O positive. In routine red cell antibody screening of donor blood samples, reaction was observed in ID-DiaCell Pool using column agglutination technique (Bio-Rad, DiaMed). As a part of institutional standard operating procedure, since the pooled screening red cell was found to be positive, we proceeded with 3-red cell panel (Bio-Rad ID-DiaCell I, II, III Asia [Mia+]) and 11-red cell antibody identification panel (Bio-Rad 11 × 4). Reactivity pattern was observed in screening red cell panel [Table 1], and antibody was found to be anti-Jkb after ruling out. Donor red blood cells were phenotyped with anti-Kidd antisera, and it was found to be Jk (a+b−). Direct antiglobulin test and autocontrol were performed by column agglutination technique, and it was found to be negative. Since indirect antiglobulin test performed by tube technique was negative, antibody titration could not be performed. A donor questionnaire form was again scrutinized for any significant alloimmunization history. The donor was contacted, and it was assured that there was no history of transfusion of blood components, pregnancy, or any invasive surgical procedures. The blood components which were prepared from her donation (plasma and random donor platelet) were discarded except packed red blood cell. The donor was informed about her antibody status, and advice was given to her to inform the blood center about her antibody findings during her next donation.
Table 1: Antibody reactivity in donor plasma by using screening red cell panel

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Anti-Kidd antibodies are well known for its peculiar feature that these antibodies, even though they are strongly reacting, may become unnoticeable from patient serum after a brief time period of alloimmunization stimulus. These antibodies show dosage effect, and they can cause delayed hemolytic transfusion reaction. These clinically significant antibodies are immunoglobulin G, and they are reactive at 37°C.[2] Only three reported cases of naturally occurring anti-Kidd antibodies are found in the literature so far. All these three case reports, i.e., Rumsey et al., Kim et al., and Shastry et al., explain about the naturally occurring Anti-Jka antibody.[3],[4],[5] Our report is the first to explain about naturally occurring Anti-Jkb antibody in a voluntary blood donor. Hence, our finding will necessitate the importance of comprehensive and sensitive methods of antibody screening.

Acknowledgment

I acknowledge my technical staff for helping me out in solving the immunohematological workup.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Holodick NE, Rodríguez-Zhurbenko N, Hernández AM. Defining Natural Antibodies. Front Immunol 2017;8:872.  Back to cited text no. 1
    
2.
Makroo RN, Nayak S, Chowdhry M, Karna P. Facts and fallacies of kidd antibodies: Experience in a Tertiary Care Hospital in North India. Indian J Hematol Blood Transfus 2017;33:254-8.  Back to cited text no. 2
    
3.
Rumsey DH, Nance SJ, Rubino M, Sandler SG. Naturally-occurring anti-Jka in infant twins. Immunohematology 1999;15:159-62.  Back to cited text no. 3
    
4.
Kim HH, Park TS, Lee W, Lee SD, Kim HO. Naturally occurring anti-Jk(a). Transfusion 2005;45:1043-4.  Back to cited text no. 4
    
5.
Shastry S, Bhat SS, Raturi M, Shivhare A. Further evidence for naturally occurring anti Jk(a) antibodies. Asian J Transfus Sci 2015;9:107.  Back to cited text no. 5
    



 
 
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