Clinically Significant IgM Anti-C^w: A Rare Report

Excerpt

A 23-year-old primigravida Rh ‘D’ negative female visited the Rh clinic for indirect antiglobulin test (IAT). Her blood group was B Rh D negative and her husband’s blood group was B Rh D positive. IAT was positive (strength +3) by gel technique (ID-Micro Typing System, DiaMed AG 1785 Cressier, Switzerland) on LISS/Coombs cards (DiaMed GmbH 1785 Cressier, Switzerland) using commercial pooled cells (ID-DiaCell pool DiaMed GmbH 1785 Cressier, Switzerland). Further, anti-C^w antibody was identified on antibody screen (ID-DiaCell I–II–III, DiaMed GmbH 1785 Cressier, Switzerland) and identification (ID-DiaCell Panel, DiaMed GmbH 1785 Cressier, Switzerland). Anti-C^w showed wide thermal amplitude by tube technique (room temperature +1, 4 °C +2 and 37 °C +1). Antibody was IgM type as antibody screen after dithiothreitol (DTT) treatment using proper controls was negative. Both wife and husband were negative for C^w antigen. There was no history of blood transfusion in the patient. For other Rh antigens, the patient’s red cells typed as C+ c− E+ e− and her husband’s as C+ c+ E+ e+. Antibody titres by tube technique were negative in 1:2, however by gel technique they were 1:8. The patient delivered at 37 weeks and the baby’s haemoglobin was 19.2 gm/dl and serum bilirubin of cord sample was 5.6 mg/dl. Baby’s blood group was B Rh D positive and direct antiglobulin test (DAT) was negative using polyspecific antihuman globulin (Biorad Diaclon Coombs sera, polyvalent rabbit anti-IgG and monoclonal anti-C3d). Newborn’s red cells were negative for C^w antigen. …