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The page below is a sample from the LabCE course Overview Of Major Antigens of the Rh Blood Group System. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Alterations in D Antigen Expression

When routine testing of red cell samples is performed using commercially prepared anti-D reagents, positive reactivity is expected to be strong. However, in some instances this reactivity may be weaker or not observed at room temperature immediate spin. Testing through the immunoglobulin phase may be required in order to detect the D antigen. Historically these samples were referred to as Du type. Based on the lack of production of anti-Du it was determined that this was not a new antigen. In some cases, in fact, individuals identified as Du produced anti-D. These individuals are now categorized into different phenotypes defined by the mechanism that brings about the alteration of the D antigen expression.

Harmening, DM,: Modern Blood Banking & Transfusion Practices, 6th ed. FA Davis, Philadelphia, PA, 2012, p 158.
Blaney, KD and Howard, PR: Basic & Applied Concepts of Blood Banking and Transfusion Practices, 3rd ed. Elsevier, St. Louis, MO, 2013, p 112-114.