A novel silent RHCE allele in Chinese population.

OBJECTIVES:We aimed to analyse the molecular backgrounds of the family in which an eight-day-old baby was confirmed to have hemolytic disease of the newborn (HDN) and phenotype observed for the baby did not conform to the expected phenotype. BACKGROUND:The silent RHCE allele is rare in the Rh system. METHODS:To determine the antibody specificity, her family members' blood samples were collected and tested using routine serological methods. The Rh C + c-e + E- phenotype observed for the baby did not conform to the expected phenotype based on the maternal RhC-c + E + e- phenotype. The RH genes of the family members were further analysed by sequencing. RESULTS:The Rh phenotypes of the baby, her brother, her mother and father were CCDee, CcDEe, ccDEE and CCDee, respectively. IgG anti-e was confirmed to cause the HDN in the case. A heterozygous silent RHCE * 03(c.1059G > A) mutation in exon 7 was found in the baby and her mother, which is a novel nonsense allele caused by a premature termination codon (Trp353stop). CONCLUSION:The silent RHCE * 03(c.1059G > A) variant was observed in a heterozygous state in mother and baby. We predict that, had this occurred in the homozygous state, it would give rise to the rare D-- phenotype. To enhance the safety of transfusion, considerable attention should be paid to the RHCE gene in the Chinese population.

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