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The novel in‐frame deletion is associated with a considerably reduced expression of D antigen and a variant RhD phenotype. The mutation occurs in close proximity to the first exofacial loop of the protein which is mainly encoded by sequences of Exon 1. Structural changes caused by the deletion may reach the surface of the protein in this region. Consistent with the substantially weakened agglutination reactions observed with anti‐D LHM59/19, the presence of an altered Loop 1–dependent epitope 8.15 appears to be possible. Although all the anti‐Ds we used to examine the epitope pattern reacted positive with the proposita's RBCs, the presence of a qualitatively altered D antigen may not be excluded. The primigravida had not received prenatal or postnatal RhIG prophylaxis. Though pregnant with a D‐positive fetus, no immunization was observed; however, whether this novel D variant permits anti‐D immunization remains unclear. Hence, D‐negative transfusion in carriers and prophylactic use of RhIG in pregnancy is recommended. DMW expands the exceptionally rare RHD in‐frame deletions reported and should be regarded as a putative partial D allele.

Granulocyte-reactive antibodies may cause transfusion-related acute lung injury (TRALI) and immune neutropenias. Risk factors for their acquisition other than previous alloexposition are largely unknown. In addition to the known association between human leucocyte antigen alloantibodies and red blood cell alloimmunization in selected cohorts of transfused patients, this study investigated a possible extension of this association to granulocyte-reactive antibodies in women with a history of pregnancy. The overall prevalence of granulocyte-reactive antibodies in 333 samples from women with a history of pregnancy (143 samples containing red cell alloantibodies) was 23·1%. The prevalence in the red cell-alloimmunized group (32·9%) was significantly higher than in controls (15·8%, P