A LU:-16 individual with antibodies.

Area of Science:

• Immunohematology
• Genetics
• Transfusion Medicine

Background:

• The Lutheran blood group system is important in transfusion medicine and pregnancy.
• Antibodies against Lutheran antigens can cause transfusion reactions and hemolytic disease of the fetus and newborn.
• The Lu(a+b-) phenotype is rare, particularly in individuals of African descent.

Purpose of the Study:

• To investigate the cause of multiple antibodies identified in a pregnant woman of African descent.
• To characterize the specific Lutheran blood group antigens targeted by the antibodies.
• To determine the genetic basis of the observed Lutheran blood group phenotype.

Main Methods:

• Immunohematological testing including antibody identification and red blood cell (RBC) phenotyping.
• Autologous donations for transfusion preparation.
• LU cDNA sequence analysis to identify genetic variations.
• Testing against Lu(a-b-) reagent RBCs with known and unknown genetic backgrounds.

Main Results:

• A pregnant woman of African descent with Lu(a+b-) phenotype developed antibodies including anti-Lea and anti-Lub.
• A third antibody targeting a high-prevalence Lutheran antigen was detected.
• LU cDNA sequence analysis revealed specific mutations (c.230G>A, c.679C>T, c.1227G>T), strongly suggesting anti-Lu16.
• This represents the fifth reported case of LU:-16 associated with antibodies in women of African heritage.

Conclusions:

• The study identified anti-Lu16 in a pregnant woman with the rare Lu(a+b-) phenotype and African heritage.
• Despite the presence of antibodies, hemolytic disease of the fetus and newborn was not observed in this case.
• This case contributes to the understanding of rare Lutheran blood group phenotypes and alloimmunization.