궤양성 대장염 환자에게서 동정된 항-LebH 항체 1례
A Case of Anti-LebH Antibody Identified in a Patient with Ulcerative Colitis
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환자는 이전에 궤양성 대장염을 진단받은 67세 남자로 배변 곤란을 호소하여 직장 풍선 확장술을 시도하였으나 실패하였다. 환자는 수술적 치료를 위해 외과로 전과되었다. 수술 전에 검사한 환자의 혈액형은 A, Rh(D) 양성이었다. 비예기항체 선별검사는 양성으로 나타났고, 비예기항체 동정검사 결과는 전형적이지 않았다. 발견된 항체의 반응성은 항-Leb 항체와 유사하였으나 papain 처리 후에는 패널의 모든 적혈구와 양성반응을 보였다. 이 항체는 A, Le(a−b+) 혈구보다 O형 적혈구와 더 큰 반응성을 보여 항-LebH 항체로 결론지을 수 있었다. Lewis 표현형은 재검 후 Le(a−b−)로 나타났다. 환자의 Lewis 혈액형 확인을 위해 FUT2, FUT3 유전자에 대해 염기서열분석을 시행한 결과, FUT3 유전자에서 c.59T>G 변이와 c.1067T>A 변이가 발견되었다. 따라서 환자의 Lewis 혈액형은 Le(a−b−)로 결론지었다
Abstract
A 67-year-old man previously diagnosed with ulcerative colitis complained of difficulty in defecation and underwent balloon dilatation of rectum, but the procedure failed. The patient was transferred to a surgical department for further treatment. Before surgery, his red cells were typed A, Rh(D) positive. The antibody screening test was positive and the results of the identification tests were atypical. The reactivity was similar to anti-Leb antibody; however, the antibody showed panreactivity against papainized red cells. It showed stronger reactivity against O red cells than A Le(a−b+) red cells, and we concluded that the antibody was anti-LebH. After reexamination, his Lewis phenotype was found to be Le(a−b−). His FUT2 and FUT3 were analyzed to confirm his Lewis blood type, and c.59T>G and c.1067T>A variants were found on the FUT3. Therefore, the patient's Lewis blood type was concluded as Le(a−b−).
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