Can serological methods help distinguish between prophylactic and alloimmune anti-D?

C. Irving, M. Crennan, T. Vanniasinkam

Research output: Contribution to journalArticle

1 Citation (Scopus)


Objectives: Enzyme indirect antiglobulin test (EIAT) and polyethylene glycol IAT (PIAT) were evaluated for their potential use as tests to distinguish between prophylactic and alloimmune anti-D in plasma by comparing with a tube variation of the standard low ionic strength solution-IAT (LISS-IAT).
Background: Laboratories performing the screening of RhD-negative pregnant women are required to provide clinicians with guidance as to the source of detected RhD antibodies. Currently, this is derived from RhIg immunoprophylaxis history, agglutination scores and titration results, where performed. A serological test that can differentiate between prophylactic and alloimmune anti-D would be useful in the diagnosis of RhDalloimmunisation in pregnant women.
Materials and Methods: Plasma samples (n = 273) [fresh (collected from April 2014 to February 2015) and frozen (up to 2years)] from antenatal females, preoperative males and females over child-bearing age were used in this study. Samples were identified as containing anti-D by routine column agglutination(CAT) and were tested by tube LISS-IAT, EIAT and PIAT, and a score difference was calculated.
Results: A total of 32% of alloimmune anti-D samples demonstrated an increase in agglutination score (+2or+3) when tested by EIAT. A significant increase in agglutination score for alloimmune samples using EIAT compared with LISS-IAT was observed. EIAT had a sensitivity (Sn) of 59%, positive predictive value (PPV) of 100% and specificity (Sp) of 100% for alloimmune anti-D.
Conclusion: EIAT is capable of confirming but not excluding the presence of alloimmune anti-D in samples where anti-D is detected in routine antibody screening.
Original languageEnglish
Pages (from-to)362-368
Number of pages7
JournalTransfusion Medicine
Issue number5
Early online dateMay 2017
Publication statusPublished - Oct 2017

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