{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T03:43:00Z","timestamp":1791776580214,"version":"4.3.4"},"reference-count":10,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,5,6]],"date-time":"2024-05-06T00:00:00Z","timestamp":1714953600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion Medicine"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The Rh system is an extremely important RBC antigen system with over 50 antigens, 5 of which (D, C, E, c and e) are considered most clinically significant. The rare Rhnull phenotype can result from mutations in the RHD and RHCE genes or the RHAG gene that affects their expression. This is a case report of the second type.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case Report<\/jats:title><jats:p>This case reports a multiparous lady who had to be evaluated for a panreactive antibody. The discrepancy was first identified at the centre she reported to. A thorough immunohematological workup was performed at a second reference laboratory. Suspecting Rhnull phenotype, a third referral (molecular typing) was requested at International Blood Group Reference Laboratory (IBGRL), Bristol.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A novel RHAG null allele (c.1138+2t&gt;a), causing a Rhnull phenotype was identified. The antibody was most likely an anti\u2010Rh 29 antibody.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The novel c.1138+2 t\u2009&gt;\u2009a mutation in the RHAG gene causing the Rhnull phenotype and development of a pan reacting antibody(ies) made the patient's pregnancy challenging. Confirmation of the diagnosis, an important step in her management, required use of both serological immunohematology and molecular techniques.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tme.13045","type":"journal-article","created":{"date-parts":[[2024,5,7]],"date-time":"2024-05-07T05:18:43Z","timestamp":1715059123000},"page":"223-226","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Rh<sub>null<\/sub> phenotype in an Indian patient due to a novel c.1138\u2009+\u20092\u2009t\u2009&gt;\u2009a mutation in the <i>RHAG<\/i> gene"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9238-6657","authenticated-orcid":false,"given":"Soumee","family":"Banerjee","sequence":"first","affiliation":[{"name":"Rotary TTK Blood Centre Bangalore Medical Services Trust  Bangalore India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ankit","family":"Mathur","sequence":"additional","affiliation":[{"name":"Rotary TTK Blood Centre Bangalore Medical Services Trust  Bangalore India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neha","family":"Hurkat","sequence":"additional","affiliation":[{"name":"Department of Transfusion Medicine and Transplant Immunology Yashoda Hospital  Secundrabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santanu","family":"Chakraborty","sequence":"additional","affiliation":[{"name":"Rotary TTK Blood Centre Bangalore Medical Services Trust  Bangalore India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. V.","family":"Reddy","sequence":"additional","affiliation":[{"name":"Rotary TTK Blood Centre Bangalore Medical Services Trust  Bangalore India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,5,6]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"Human Blood Groups","author":"Daniels G","year":"2008"},{"key":"e_1_2_10_3_1","first-page":"150","volume-title":"Modern Blood Banking and Transfusion Practises","author":"Harmening D","year":"2012"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(01)07069-6"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1053\/beha.1999.0047"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V91.4.1458"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V92.2.639"},{"key":"e_1_2_10_8_1","first-page":"219","article-title":"Two\u2010step approaches for RHD gene analysis of RhD negatives and variants and the discovery of a new allele","volume":"24","author":"Lu SS","year":"2011","journal-title":"Chin J Blood Transfus"},{"key":"e_1_2_10_9_1","unstructured":"International Society of Blood Transfusion.Table of Blood Group Systems v 6.0_6th August.2019. Accessed December 31 2022http:\/\/isbtweb.org\/working-parties\/redcell-immunogenetics-and-blood-group-terminology\/"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/tme.12697"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1423\u20100410.1987.tb04938.x"}],"container-title":["Transfusion Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tme.13045","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,2]],"date-time":"2024-07-02T03:55:52Z","timestamp":1719892552000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tme.13045"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,6]]},"references-count":10,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,6]]}},"alternative-id":["10.1111\/tme.13045"],"URL":"https:\/\/doi.org\/10.1111\/tme.13045","archive":["Portico"],"relation":{},"ISSN":["0958-7578","1365-3148"],"issn-type":[{"value":"0958-7578","type":"print"},{"value":"1365-3148","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,6]]},"assertion":[{"value":"2023-07-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-13","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-06","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}