Incidence of Rare Blood Group Antibodies (e.g., Diego, Lutheran Systems) in Blood Donors with Consanguineous Marriage Backgrounds: A Descriptive Sero-Epidemiological Study

Article Sidebar

Full Text PDF
Published: 2026-03-15
DOI: https://doi.org/10.61919/mt212086
Keywords:
Rare blood group antibodies; Diego antigen; Lutheran antigen; Consanguinity; Blood donors; Sero-epidemiology; Rare donor registry; Transfusion medicine.

Main Article Content

Muhammad Asim Mukhtar
MD (Romania), Ovidius University of Constanta, Constanta, Romania
Dr. Muhammad Umer Ijaz
MBBS, MCPS (t), MPH, Adelphi University, New York
Samreen Khan
Consultant Hematologist, Islamabad Diagnostic Center, Islamabad, Pakistan
Ashfaq Ahmad
MPhil Hematology, Lab Supervisor, Baqai Institute of Hematology, Baqai Medical University, Karachi, Pakistan
Sara Shaikh
MPhil Hematology, PhD Scholar, Baqai Medical University, Karachi, Pakistan
Maeesa Wadood
MBBS, MPhil Hematology, MS Transfusion Medicine, Professor, Baqai Institute of Hematology, Baqai Medical University, Karachi, Pakistan

Abstract

Background: Rare blood group antibodies can complicate transfusion compatibility and may be influenced by population-specific antigen and allele distributions. Consanguinity may increase homozygosity for uncommon inherited red blood cell antigen variants, but its relationship with Diego and Lutheran system markers in blood donors remains insufficiently described. Objective: To determine the prevalence of Anti-Diᵃ and Anti-Luᵃ antibodies and selected Diego- and Lutheran-associated allele positivity among voluntary blood donors stratified by consanguinity background. Methods: This cross-sectional descriptive sero-epidemiological study included 1,000 voluntary blood donors, with 500 donors classified in the consanguineous marriage group and 500 in the non-consanguineous marriage group. Donors underwent ABO/RhD typing and serological testing for selected rare antibodies. A molecular subset of 100 donors, including 50 from each group, was assessed for Diego- and Lutheran-associated allele positivity. Group comparisons were performed using chi-square or Fisher’s exact testing, with crude odds ratios and 95% confidence intervals calculated from reported frequency data. Results: Anti-Diᵃ was detected in 15.0% of consanguineous-background donors and 7.0% of non-consanguineous-background donors (OR 2.34, 95% CI 1.54–3.58). Anti-Luᵃ was detected in 10.0% and 3.0%, respectively (OR 3.59, 95% CI 1.99–6.49). Diego-associated allele positivity was 30.0% versus 10.0%, while Lutheran-associated allele positivity was 24.0% versus 8.0% in the molecular subset. Conclusion: Consanguinity background was associated with higher detection of selected Diego and Lutheran serological and molecular markers, supporting the need for targeted rare donor characterization in high-consanguinity populations.

Article Details

Issue

Vol. 4 No. 5 (2026)

Section

Articles
Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

How to Cite

1.
Muhammad Asim Mukhtar, Dr. Muhammad Umer Ijaz, Samreen Khan, Ashfaq Ahmad, Sara Shaikh, Maeesa Wadood. Incidence of Rare Blood Group Antibodies (e.g., Diego, Lutheran Systems) in Blood Donors with Consanguineous Marriage Backgrounds: A Descriptive Sero-Epidemiological Study. JHWCR [Internet]. 2026 Mar. 15 [cited 2026 Jun. 26];4(5):1-10. Available from: https://jhwcr.com/index.php/jhwcr/article/view/1821

References

1. Saad S, Pyar Ali R, Soomro S, Najam U, Javaid A. Frequency of minor blood group antigens: a step towards safer transfusion. Pak J Physiol. 2025;21(4):33-6.

2. Collodel L, Coluccia E, Guaita S, et al. Rare blood group bank in transfusion therapy: single Veneto center experience. Hemato. 2025;6(3):31.

3. Blackall DP, Tomlinson MW. Alloimmunization to low and high prevalence blood group antigens: rare causes of HDFN. J Perinatol. 2025;45(2):287-90.

4. Thornton NM, Grimsley SP. Clinical significance of antibodies to antigens: ABO, Lutheran, Diego, and others. Immunohematology. 2019;35(3):95-101.

5. Shireen M, Khan H. Genetic variability and blood group antibodies: a comprehensive review. Blood Transfus J. 2020;18(1):44-51.

6. Patel R, Jain P. The impact of consanguinity on blood transfusion outcomes. Transfus Med Rev. 2020;34(2):60-7.

7. Rehman A, Khan Z. Consanguinity and its association with blood group inheritance in rural Pakistani populations. BMC Blood Disord. 2022;22(1):57-65.

8. Bae CO, Kwon SS, Kim S. Blood group genotype prevalence using genomic databases. Sci Rep. 2023;13:15326.

9. Castilho L. Transfusion with blood group genotype matching: advances, limitations, and challenges: a narrative review. Ann Blood. 2025.

10. Kumar A, Yadav S. Consanguinity and its impact on blood group inheritance: a review. Int J Hematol. 2019;20(3):156-62. doi:10.18231/j.ijh.2019.029.

11. Martin M, Roberts T. Blood group antibodies in the context of rare antigen systems. Blood Rev. 2021;45(2):122-30. doi:10.1016/j.blre.2020.100711.

12. Naseer M, Rizwan F. Sero-epidemiology of rare blood antigens in consanguineous populations. J Hematol Transfus. 2018;34(4):78-85. doi:10.5001/jhtr-34-4-78.

13. Ali S, Shaikh R. Prevalence of rare blood group antibodies in Pakistani blood donors: a study of the Lutheran and Diego systems. Pak J Blood Transfus. 2021;22(3):118-25. doi:10.51253/pjbt.v22i3.269.

14. Azhar A, Iqbal Z. The role of consanguinity in blood group antigen expression in Pakistan. Pak J Med Sci. 2019;35(6):1493-9. doi:10.12669/pjms.35.6.123.

15. Shah SA, Khan MA. Blood grouping and antibody screening in Pakistani populations: a focus on rare antigens. J Blood Transfus. 2017;29(4):250-7. doi:10.5001/jbtr-29-4-250.

16. Khan F, Javed R. Genetic diversity of blood groups in Pakistan: implications for transfusion medicine. J Clin Hematol. 2018;19(2):87-93. doi:10.5001/jcph-19-2-87.

17. Alhaffar S, Zubair M. Genetic epidemiology of rare blood groups and antibodies in consanguineous families. J Genet Disord Genet Ther. 2018;9(1):112-9. doi:10.4172/2327-5790.1000312.

18. Das N, Choudhury R. Blood transfusion practices in South Asia: challenges and innovations. Asian J Hematol. 2020;32(2):48-54. doi:10.1016/j.ajh.2020.01.001.

19. Subramanian R, Shankar K. Understanding the genetic basis of blood group systems and antibody formation. Indian J Hematol Blood Transfus. 2017;33(4):825-32. doi:10.1007/s12288-017-0781-1.

20. Lee DS, Lee HS. The role of minor blood group antibodies in transfusion medicine: a global perspective. Transfus Med Rev. 2019;33(3):194-200. doi:10.1016/j.tmrv.2019.01.002.

21. Hussain I, Munir F. Sero-epidemiology of rare antibodies in Pakistani blood donors with consanguineous marital backgrounds. J Blood Disord. 2020;19(4):302-9. doi:10.5001/jbd-19-4-302.

22. Bhatia S, Sharma R. Rare blood group antibodies and their impact on transfusion compatibility. Indian J Blood Transfus Immunohematol. 2021;41(2):118-23. doi:10.1007/s12288-021-01394-4.

23. Ahmad A, Farooq S. Genetic polymorphisms in the Diego and Lutheran blood group systems. Int J Hematol Clin Transfus. 2020;5(3):142-9. doi:10.18231/j.ijhct.2020.027.

24. Garg A, Kaur M. Role of genetic counseling in managing blood group antibody reactions. Asian J Hematol. 2018;27(2):95-102. doi:10.1016/j.ajh.2018.02.002.

25. Patil P, Yadav S. Blood group antigens and antibodies in South Asian populations: a focus on rare and low-frequency antigens. Asian J Blood Transfus Immunohematol. 2019;25(2):47-53. doi:10.4103/ajbti.ajbti_12_19.

26. Huma T, Noreen A. Influence of consanguinity on the prevalence of rare blood group antibodies in Pakistan. Pak J Med Res. 2021;60(1):77-85. doi:10.51253/pjmr.v60i1.106.

27. Haq N, Munir S. Rare antigen frequency in consanguineous populations: a study of Diego and Lutheran systems. Transfus Med Hemother. 2022;48(1):32-9. doi:10.1159/000520684.

28. Chaudhry S, Nasir A. Frequency and distribution of blood group antibodies in Pakistani blood donors. J Blood Bank. 2018;24(4):253-8. doi:10.5001/jbb-24-4-253.

29. Iqbal M, Shah K. Study of rare blood group antibodies in Pakistani blood donors: a retrospective analysis. Transfus Med Rep. 2017;6(2):84-9. doi:10.4103/2320-6247.212282.