Rh-hr Genotype With ABO Grouping

CPT: 86900; 86906
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Test Details

Synonyms

  • Rh Genotype
  • Rh-hr Genotype

Test Includes

Tests for ABO blood grouping and the the Rh antigens D, C, E, c, and e (including test for “weak D,” if applicable)

Use

Determine ABO blood grouping and most probable zygosity for D(Rho) antigen. Zygosity for C, E, c, and e antigens is also determined. Paternal typing may aid in the prediction of Rh hemolytic disease of the newborn.

Limitations

Abnormal plasma proteins, potent cold autoagglutinins, positive direct antiglobulin test, and in some cases bacteremia may interfere with test interpretation. Variable testing results may be observed with partial antigens which are rare variants of the Rho(D) antigen.

Methodology

Hemagglutination

Additional Information

When a woman of childbearing age has anti-D, it is important for prognostic purposes to determine the probability that her husband is homozygous or heterozygous for the gene determining the D antigen. If a prenatal patient is Rh-negative and the father of her fetus is homozygous for D, the child will always be Rh positive. Approximately 50% of the children of a heterozygous father will be Rh-negative. Testing to determine zygosity involves testing the subject's red blood cells for D, C, E, c, and e antigens. The results of this testing are referred to as the Rh phenotype. The Rh phenotype is used to determine a “most probable” zygosity for D based upon correlation of these results with a frequency chart detailing most probable Rh genotypes. In the case of D, this must be done indirectly since there is no detectable allele for this gene. In the case of the alleles C and c and the alleles E and e, the zygosity of these genes may be directly determined from the phenotyping results. Rh phenotyping of the father may also be helpful for evaluating the potential for hemolytic disease of the newborn in the presence of maternal antibodies to C, c, E, or e antigens. See table.

Interpretation of Rh Phenotype Results in the Rh-positive Population1

Red Cell Antigen Typing

Most Probable Genotype

% Likelihood of Being Homozygous for D

D

C

E

c

e

Caucasian

Black

Mestizo*

White

Black

Mestizo*

For further information, please contact LabCorp or consult the source for this chart.

From American Association of Blood Banks. Technical Manual. 15th ed. Bethesda, Md: AABB Press; 2005.

*Mestizo frequencies were derived from a study of Mexican and Mexican-American population studies. The term “Mestizo” is commonly used in Hispanic countries to describe persons of mixed European and American Indian ancestry.

+

+

O

+

+

CDe/cde

CDe/cDe

CDe/cde

10

59

15

+

+

O

O

+

CDe/CDe

CDe/CDe

CDe/CDe

91

81

96

+

O

+

+

+

cDE/cde

cDE/cDe

cDE/cde

10

63

15

+

O

+

+

O

cDE/cDE

cDE/cDE

cDE/cDE

87

99

98

+

+

+

+

+

CDe/cDE

CDe/cDE

CDe/cDE

89

90

97

+

O

O

+

+

cDe/cde

cDe/cde

cDe/cde

6

46

8

Specimen Requirements

Specimen

Whole blood

Volume

4 mL

Minimum Volume

1 mL

Container

Lavender-top (EDTA) tube

Storage Instructions

Specimens should be tested as soon as possible or within 72 hours of collection. Samples that cannot be tested immediately should be stored at 2°C to 8°C. Do not freeze red cells.

Causes for Rejection

Gross hemolysis; bacterial or other contamination

Clinical Information

Footnotes

1. Means ND, Bandarenko N, Moise KJ Jr, Brecher ME. Likelihood of D heterozygosity in Mestizo Mexicans and Mexican Americans. Immunohematology. 2001; 17(1):22-23. 15373600

References

Fung MK, Grossman JB, Hillyer CD, Westoff CM, eds. AABB Technical Manual. 18th ed. Bethesda, Md: American Association of Blood Banks;2014.

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
058008 Rh-hr Genotype w/ABO Grouping 006586 Rh-hr Genotype: N/A
058008 Rh-hr Genotype w/ABO Grouping 006057 Blood Grouping: 883-9
058008 Rh-hr Genotype w/ABO Grouping 016485 Rh(D) 1305-2
058008 Rh-hr Genotype w/ABO Grouping 016493 C 948-0
058008 Rh-hr Genotype w/ABO Grouping 016501 E 1021-5
058008 Rh-hr Genotype w/ABO Grouping 016519 c 1159-3
058008 Rh-hr Genotype w/ABO Grouping 016527 e 1165-0
058008 Rh-hr Genotype w/ABO Grouping 006587 Rh-Genotype w/ABO 1314-4

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