[Study on the Production of Anti-D and Anti-E Mixed Antibodies by Alloimmunization in RhD Variant Type33 Recipients].

Objective: To investigate the cause of the production of anti-D and anti-E mixed antibody in an RhD positive patient.

Methods: The ABO/Rh blood group typing and irregular antibody specificity were identified by conventional serological methods, the RHD gene exon 1-10 and heterozygous analysis were performed by sequence-specific primer polymerase chain reaction (PCR-SSP), and the whole exon sequence was analyzed by first-generation sequencing.

Results: The patient's Rh blood group was weak D Type33, with the allele was RHD*01W.33, the patients was found to be RhD⁺/RHD^- heterozygous, with an Rh typing of Ccee, and the patient had developed anti-D combined with anti-E mixed antibodies.

Conclusion: The patient has A c.520G>A mutation in exon 4 of the RHD gene, to lead decreased expression of RhD antigen in red blood cells and the anti-D and anti-E mixed antibodies were produced by transfusion immunostimulation.