The first case of congenital blood chimerism in two of the triplets in Korea

• Published in: Journal of clinical laboratory analysis Vol. 32; no. 8; pp. e22580 - n/a
• Main Authors: Chung, Yoo Na, Chun, Sejong, Phan, Minh‐Trang Thi, Nam, Myung‐Hyun, Choi, Byung Min, Cho, Duck, Choi, Ji Seon
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.10.2018; John Wiley and Sons Inc
• Subjects: ABO Blood-Group System - genetics; ABO system; Agglutination; allele‐specific polymerase chain reaction (AS‐PCR); blood chimerism; Blood groups; Brief Report; Chimeras; Chimerism; direct sequencing; Exons; flow cytometric analysis; Flow cytometry; Genotypes; Humans; Infant, Newborn; Molecular Diagnostic Techniques; Monoclonal antibodies; Neonates; Pedigree; Polymerase chain reaction; Republic of Korea; triplets; Triplets - genetics; Zygotes; blood chimerism; direct sequencing; allele-specific polymerase chain reaction (AS-PCR); flow cytometric analysis; triplets
• ISSN: 0887-8013; 1098-2825
• DOI: 10.1002/jcla.22580

Background Chimeras are composed of two or more different populations that originated from different zygotes. Blood chimerism arising from twins have been reported in the literature. Herein, we report the first blood group chimerism in triplets. Methods ABO blood grouping was carried out by manual tile methods (Merck Millipore, UK) and micro‐column agglutination method (Bio‐Rad, Cressier sur Morat, Switzerland). Flow cytometric analysis was performed with Anti‐A‐PE conjugated monoclonal antibodies (BD Biosciences, San Jose, CA, USA) and FACS Canto II (BD Biosciences). Molecular analysis was performed with allele‐specific polymerase chain reaction (AS‐PCR) and direct sequencing of the exons 6 and 7. Results Mixed‐field agglutination and weak agglutination against anti‐A were revealed by ABO blood grouping. Flow cytometric analysis revealed the presence of both A cells and O cells. AS‐PCR and sequencing showed two neonates with chimerism, with each neonate`s genotype being A102/O01/O02. Conclusion This is the first recorded case of blood chimera from a triplet in Korea. We recommend full investigation of blood group chimerism in neonates with ABO discrepancy, as blood chimerism is subject to certain caution in the clinical environment.