ANTI C WILLIS ANTIBODY IN MULTITRANSFUSED THALASSEMICS:

REPORT OF 3 CASES.
Shivali Sehgal, Sangeeta Pahuja, Geetika Sharma, Sunita Sharma
Department of Blood Bank & Pathology, Lady Hardinge Medical College, New Delhi
INTRODUCTION
•Anti C Willis (Anti Cw) is an antibody against the the Cw (Rh8) antigen, which is a low incidence antigen of the Rh system
•Production of Anti Cw can occur in response to the presence of Cw antigen on the membranes of donor red cells
•This antibody may be seen in combination with other antibodies to red blood cells
AIM
To report 3 cases of alloimmunization against Cw antigen in multitransfused thalassemic patients
MATERIALS AND METHODS
Antibody screening (using Biorad ID-DiaPanel) was done in all recipients before each transfusion
If positive, antibody identification (using Biorad ID-Diacell I-II-II Asia) was performed
RESULTS
Out of 567 thalassemic patients registered in blood bank, anti Cw was detected in three cases giving an incidence of 0.53%
Patient Sex Current Age Age at the time of Blood group Status of Detection of Anti Cw
registration at LHMC Alloimmunization
I Male 30y 21y O+ anti Cw2y post registration
II Female 27y 18y B+ anti Cw + anti E
At registration,
Undetectable since
5y
III Male 4y 2y A+ anti Cw At registration,
Undetectable since
1y
These patients are issued blood with Cw negative antigen profile irrespective of the detection of anti Cw by antibody
screening and identification
DISCUSSION
Cw antigen is found in about 2 percent of the whites and is very rare in blacks
Cw results from a single amino acid change (Gln41Arg) most often found on the RhCe protein
Anti Cw antibody is usually of the IgG type and may show dosage (reacting more strongly with cells from individuals who
are homozygous for Cw)
It may be naturally occurring or may develop after transfusion and pregnancy
It is a clinically significant antibody and has been known to cause mild to severe immediate & delayed haemolytic
transfusion reactions as well as mild to moderate haemolytic disease of the newborn
Patients with anti Cw should always receive Cw negative packed cells after Indirect Antiglobin test (IAT) cross match
Since Cw is a low prevalence antigen, Cw antigen negative blood is readily available
CONCLUSION
Physicians must be aware that occurrence of Anti Cw can lead to serious transfusion complications.
In addition, if anti Cw is identified during pregnancy, titres should be monitored throughout in order to avoid HDN
Thalassemic Patients with anti Cw should be counselled regarding the potential of the antibody to cause HDN and HTR
REFERENCES
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8) antigen in north india. Indian J Hematol Blood Transfus 2014;30:S440-4.
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