Identification results and distribution pattern of unexpected antibodies in 22 336 hospitalized pediatric patients
10.13303/j.cjbt.issn.1004-549x.2025.12.013
- VernacularTitle:22 336例住院儿童患者意外抗体鉴定结果及分布规律
- Author:
Xiaopan ZHANG
1
;
Jiali YANG
1
;
Zhihao LI
1
;
Ding ZHAO
1
;
Dongdong TIAN
1
Author Information
1. Department of Blood Transfusion, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital Zhengzhou Children's Hospital, Zhengzhou 450018, China
- Publication Type:Journal Article
- Keywords:
children;
unexpected antibodies;
Rh blood group;
MNS blood group
- From:
Chinese Journal of Blood Transfusion
2025;38(12):1735-1741
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To explore the positive rate and distribution characteristics of unexpected antibodies in hospitalized children. Methods: A total of 22 336 hospitalized pediatric patients admitted to Henan Children's Hospital from August 2018 to September 2022 were selected as the research subjects, and their relevant clinical data were collected. Blood samples of the patients were subjected to blood type identification and unexpected antibody screening. For samples with positive screening results, further antibody specificity identification was conducted using panel cells. The distribution patterns of unexpected antibodies across different genders, age groups, blood types, and disease categories were analyzed, and inter-group differences were compared. Results: Of the 22 336 patients, 286 (1.3%) tested positive for unexpected antibodies. The most frequently identified specificities belonged to the MNS blood group system (45.1%, 129/286), followed by the Rh system (24.5%, 70/286) and antibodies of undetermined specificity (24.5%, 70/286). Less common specificities included those from the P blood group system (2.4%, 7/286), Lewis blood group system (1.4%, 4/286), mixed antibodies from multiple systems (0.9%, 3/286), drug-induced antibodies (0.7%, 2/286), and LW blood group system (0.3%, 1/286). Within the MNS blood group system, anti-M was the most prevalent (129 cases). In the Rh blood group system, anti-E (30 cases, 10.5%) and anti-D (28 cases, 9.8%) were the main antibodies detected; other antibodies included anti-DE (4 cases, 1.4%), anti-DC (3 cases, 1.0%), anti-Ec (3 cases, 1.0%), and anti-c (2 cases, 0.7%). Only anti-P
was identified in the P blood group system (7 cases), while anti-Lea was found in the Lewis blood group system (4 cases) and anti-LW in the LW blood group system (1 case). Mixed antibodies from multiple systems consisted of anti-D+Fy
, anti-e+Fy
, and anti-Le
+P
, with 1 case (0.3%) each. Among the antibodies with undefined specificity, 26 cases were autoantibodies. All drug-induced antibodies were anti-CD38 (2 cases). The distribution of unexpected antibodies showed statistically significant differences among different genders, ages, and ABO blood types (P<0.05). Regarding age distribution, Rh blood group antibodies associated with hemolytic disease of the fetus and newborn (HDFN) were predominant in the 0-1 month group, which differed significantly from all other age groups (P<0.001). In contrast, anti-M was predominant in children over 1 year of age (89.0%), while anti-E was detected in only 3 cases (10.0%) in children over 3 years old. After Bonferroni correction (α' = 0.003 3), a statistically significant difference was observed only between the 6-17 year group and the 1-3 year group (P=0.003). Among ABO blood types, type B had the highest antibody detection rate. Following Bonferroni correction (α' ≈ 0.008 3), a significant difference in detection rates was found solely between type B and type O blood (P=0.005), with no statistically significant differences among other blood types (P>0.008 3). Conclusion: In hospitalized pediatric patients, unexpected antibodies were mainly distributed in the MNS and Rh blood group systems, with anti-M being the most commonly detected specificity and anti-E the most prevalent within the Rh system.. Sex, age and blood type significantly influence the development of unexpected antibodies. Clinically, it is necessary to pay attention to the prenatal monitoring of unexpected antibodies in pregnant women, so as to achieve homotypic transfusion of other Rh antigens as early as possible.
