Clinical spectrum of anti-E: A thought for transfusion services

The rhesus system antigens are of immense clinical importance in transfusion medicine. They can stimulate the production of clinically significant antibodies. Anti-E is one of the most common alloantibodies reported in multi-transfused patients in India which is known to cause delayed hemolytic transfusion reaction and hemolytic disease of the fetus and newborn (HDFN). This antibody can have different clinical presentations and persist for a prolonged period in the plasma. In this case series, we report five such cases where anti-E antibodies were identified in different clinical settings. The clinical scenarios consist of HDFN, hematopoietic stem cell transplantation, and blood donors, where the anti-E antibody was detected during the immunohematological workup. The patients were managed according to the clinical spectrum of the antibody.