WOMENS-HEALTH Messages for December, 1999: Re: Antibody-E ant titers

Re: Antibody-E ant titers

From: Christine (anonymous@obgyn.net)
Wed, 1 Dec 1999 08:36:40 -0600 (CST)

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At Tue, 30 Nov 1999, Jeffrey wrote: >
>To any with knowledge:
>.In conversation with my 27 year old daughter, a Nuclear Medicine
>Technologist, she insists that, concerning her pregnancy, she has a
>problem with Antibody "E" or simply anti-E, of which I can find no
>literiture. I have heard discussion of RH factor, Anti-M and something
>of anti-D but not Anti-E. Any information to my E-Mail address would be
>appreciated.
>Thank-you.
>Jeffrey P. Jensen jensenpaul@usa.net or jensenjpaul@yahoo.com

Hi Jeffrey: E (Big E), e (little e), D, C,c are all part of the RH system. Big D is the one referred to when you say a person is "Rh Positive" (has Big D) or "Rh Negative" (doesn't have big D), but you can be Rh Negative and have big E in your blood type. These blood types are much more rare though, most people who are RH Negative are cde/cde. (homozygous for little c and litte e. There is no little d, the small letter just indicates lack of big D) Problems can arise when a woman is negative for big E and has a fetus with big E ) The first pregnancy (or miscarriage) sensitizes her and subsequent pregnancies with a E postive fetus will reactivate it which can cause hemolytic disease of the newborn, similar to the RH problem caused by anti-D which everyone is aware of and was so common in the past. (that they now use RHogram to prevent) There have been posts a few weeks ago on this topic concerning anti-c. Since your daughter knows she has an anti-E problem, she must be RH negative and has had antibody titers done which is routine, or has had a previous antibody problem. I'm curious about the details. Actually, looking at my chart, 1/3 of the population in the U.S. has a blood type where they are RH positive but negative for big E. Blood tests done periodically throughout pregnancy (antibody titers or indirect coombs test) will keep her doctor on top of the situation and be able to predict any problems with the baby. Rhogam prevents formation of anti-D in RH negative women, but there is no product for the other RH factors such as C,c,E,e. Antibody problems with those factors are statistically not as great. There are other factors involved too. Big D is a potent sensitizer, but even in the old days not all women had RH problems who should have had them. I think big E is next. When I worked in Blood Banking, anti-E was not *that* rare (even in men who had received previous transfusion).

Chris S.

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