双精子嵌合体致ABO血型正反定型不符1例  

A Case of ABO Discrepancy between Forward and Reverse Typing Resulted from Dispermic Chimerism

作　　者：朱培元[1] 严京梅 薛敏[2] 叶东[1] 姚根宏[1] 栾建凤[1] 

机构地区：[1]南京军区南京总医院输血科,210002 [2]江苏省血液中心

出　　处：《临床输血与检验》2014年第1期28-30,共3页Journal of Clinical Transfusion and Laboratory Medicine

摘　　要：目的对1例正定型呈混合凝集的ABO正反定型不符样本进行鉴定。方法采用微柱凝胶法进行ABO、RhD血型鉴定、直接抗球蛋白试验和不规则抗体筛查,PCR-SSP法进行ABO基因分型,并分析外周血染色体核型。结果先证者ABO正定型为红细胞混合凝集,反定型检出抗-A1;母亲和父亲分别为O型和AB型。先证者ABO基因座位存在O1、A201和B三个等位基因,其中O1来自母亲,A201和B来自父亲。核型分析显示先证者血液中存在46,XX和46,XY两种细胞,而父母核型正常。结论先证者为孤雌分裂产生的两个相同的卵子被两个精子受精后所产生的嵌合体。Objective To identify a case of ABO discrepancy between forward and reverse typing,which showed mixed-field agglutination of red blood cells in forward grouping.Methods Routine ABO/RhD blood group typing,direct antiglobulin test,and irregular antibody screening test were carried out by gel centrifugation.ABO genotyping was performed by a polymerase chain reaction-sequence-specific primer （PCR-SSP）.G-banded karyotype was analyzed using peripheral blood.Results As for proposita,forward typing with anti-A and anti-B sera resulted in mixed-field agglutination of red blood cells,and reverse typing detected anti-A1 but not anti-B antibody.The mother and father had blood group O and AB,respectively.The proposita had O1,A201 and B alleles in the ABO locus.O1 was a maternal allele,while A201 and B were the paternal alleles.Karyotyping indicated the existence of two cell lines in the proposita＇s blood：46,XX and 46,XY.The mother and father all had normal karyotypes.Conclusions The analysis results suggest that this proposita was produced by dispermic fertilization of two identical haploid ova formed by parthenogenetic activation.

关 键 词：ABO 混合凝集 嵌合体 

分 类 号：R457.11[医药卫生—治疗学]