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An update on the Scianna blood group system
Patricia A R Brunker1, Willy A Flegel2
1Medical Director, American Red Cross, Biomedical Services, Greater Chesapeake and Potomac Region.
Immunohematology
|June 28, 2019
Summary
The Scianna blood group system, involving the erythroid membrane associated protein (ERMAP), shows expanded population distribution with molecular testing. Awareness is heightened due to new antibody cases and transfusion reactions, emphasizing routine indirect antiglobulin testing.
Area of Science:
- Immunology
- Genetics
- Hematology
Background:
- The Scianna blood group system is defined by antigens on the erythroid membrane associated protein (ERMAP).
- Previous studies cataloged genetic variations in ERMAP, but alloantigen-associated variants were limited.
- Awareness of this system has grown with advancements in molecular testing.
Purpose of the Study:
- To provide an update on the Scianna blood group system, including genetic variation, serologic cases, and biological discoveries.
- To highlight recent findings on ERMAP genetic diversity across global populations.
- To emphasize the clinical significance of Scianna blood group antibodies and antigens.
Main Methods:
- Review of recent literature on the Scianna blood group system and ERMAP.
- Analysis of genetic variation data from diverse populations.
- Case study review of serologic findings and transfusion reactions.
- Evaluation of new serologic reagents and molecular testing applications.
Main Results:
- Expanded catalog of ERMAP genetic variation across world populations.
- Elucidation of the molecular basis for a historical serologic case.
- Identification of new cases of antibodies within the Scianna system.
- Report of the first severe hemolytic transfusion reaction attributed to anti-Sc2.
- Discovery of a wider population distribution of Scianna antigens due to molecular testing.
Conclusions:
- The Scianna blood group system update includes new insights into ERMAP genetics, serology, and clinical relevance.
- The first reported severe hemolytic transfusion reaction to anti-Sc2 underscores the importance of investigating low-prevalence antigen antibodies.
- Routine indirect antiglobulin testing is crucial for identifying antibodies in transfusion reaction investigations.
- Increased use of molecular testing has enhanced awareness and understanding of the Scianna blood group system.
- The International Society of Blood Transfusion currently recognizes seven antigens in the Scianna blood group system.
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