Severe hemolytic disease of the fetus and newborn due to anti-E and anti-Jka (original) (raw)
Related papers
Hemolytic disease of newborn due to anti-Jkb in a woman with high risk pregnancy
2010
This case illustrates the importance of blood group antibodies in antenatal serology other than Rh system as a cause of hemolytic disease of newborn (HDN). In India, antenatal antibody screening is done at majority of transfusion centers in only Rh (D) negative mothers. In this multigravida woman with high risk obstetrical history, an antenatal antibody screening by indirect antiglobulin test (IAT) was not performed as she was Rh (D) positive. Postnatal work up for the pathological jaundice in the neonate revealed that red cell alloimmunization had occurred due to anti-Jk b . We conclude that antenatal antibody screening should be done in all pregnant women irrespective of the D antigen status to detect and manage red cell alloimmunization to any other clinically significant blood group antigens.
Transfusion, 2011
Slavica Dajak, Vedran Stefanović, and Vesna Č apkun BACKGROUND: The objective was to determine clinical consequences of anti-D and non-D antibodies undetected at first-trimester screening for infant or fetus. STUDY DESIGN AND METHODS: This retrospective cohort study included all pregnant women with red blood cell (RBC) antibodies who were tested between 1993 and 2008. Data were obtained from the forms for tracking immunization at the transfusion department. Each form was analyzed for three data sets: the order of screening at which the antibodies were detected (initial or repeated screening), the order of pregnancy (first pregnancy or higher), and whether the antibodies caused severe hemolytic disease of fetus and newborn (HDFN). RESULTS: In D-women, anti-D was detected in 1.3% of cases. The anti-D was undetected in 72 (37%) cases on the first-trimester screening, of which eight cases were complicated by severe HDFN. In this group, three patients were primigravidae. An overall non-D incidence of 0.2% was observed. In 16 cases, non-D were undetected on the first-trimester screening (10 anti-c, two anti-E, two anti-C, one anti-S, and one case of anti-Rh17). Non-D antibodies undetected on initial screening caused 11 cases of severe HDFN (27% of all severe non-D HDFN). Ten of them were in multiparous women. Seven of 11 cases with severe HDFN that were missed were caused by anti-c. CONCLUSION: The third-trimester screening may detect RBC antibodies that were not present or detected on the first-trimester screening. Such screening may be especially relevant in D+ multiparous women due to the risk of HDFN. ABBREVIATIONS: HDFN = hemolytic disease of fetus and newborn; IUT = intrauterine transfusion.
Hemolytic disease of newborn caused by multiple Rh antibodies
International Journal of Contemporary Pediatrics
Hemolytic disease of Fetus and Newborn (HDFN) usually results due to natural occurring antibodies or alloimmunization in mother but the presence of multiple red cell antibodies increases the risk of development of significant HDFN. Here author reported a case of hemolytic disease of fetus and newborn in a preterm baby caused by multiple maternal antibodies. Direct Antiglobulin Test (DAT) on neonate blood sample was positive (3+) with monospecific DAT showed IgG type which was confirmed by heat elution. Antibody identification of eluate was done using commercial 11-cell panel by gel method showing specificity to anti-D and anti-C antibody which was differentiated from anti-G by sequential adsorption and elution studies. Neonate was treated with double volume exchange transfusion (DVET) using leucoreduced, irradiated O Rh D and C negative PRBC suspended in AB plasma and discharged 6th day in a stable condition. So, all pregnant women should be at least advised for ICT irrespective of ...
Obstetrical & Gynecological Survey, 2008
BACKGROUND: Hemolytic disease of the fetus and newborn (HDFN) is a severe disease, resulting from maternal red cell (RBC) alloantibodies directed against fetal RBCs. The effect of a first-trimester antibody screening program on the timely detection of HDFN caused by antibodies other than anti-D was evaluated. STUDY DESIGN AND METHODS: Nationwide, all women (1,002 in 305,000 consecutive pregnancies during 18 months) with alloantibodies other than anti-D, detected by a first-trimester antibody screen, were included in a prospective index-cohort study. In a parallel-coverage validation study, patients with HDFN caused by antibodies other than anti-D, that were missed by the screening program, were retrospectively identified.
Transfusion, 2018
The Kidd-null phenotype, Jk(a-b-), occurs in individuals who do not express the JK glycoprotein. Jk(a-b-) individuals can make an antibody against the Jk3 antigen, a high-incidence antigen present in more than 99.9% of most populations. This presents many challenges to the blood bank including identification of the antibody, masking of other antibodies, and how to provide transfusion support given the rarity of Jk3-negative blood products. Kidd antibodies may cause acute and delayed hemolytic reactions as well as hemolytic disease of the fetus and newborn (HDFN). In this article, we present a series of four practical cases of pregnant women with the anti-Jk3 alloantibody that demonstrate a range of clinical presentations of Kidd-related HDFN. We retrospectively reviewed the clinical and blood bank records for four patients and their newborns encountered at institutions in Tennessee, Missouri, Hawaii, and Guam with an anti-Jk3 identified during pregnancy. Two cases showed no signific...
ARC Journal of Gynecology and Obstetrics, 2017
Background: Hemolytic disease of the newborn is still a matter of concern, due to the morbidity and mortality that can produce in the fetuses and newborns affected. Many different RBC alloantibodies can produce the disease, being anti-D the most frequently implicated followed by anti-c, anti-K and anti-E. Our objective was to analyse the prevalence of RBC significant alloantibodies in pregnant women of our area. In addition, follow-up of deliveries and newborns was performed in order to evaluate the hemolytic potential of the different alloantibodies. Materials and methods: We retrospectively reviewed pregnancies that were positive screened for RBC antibodies for a five-year period. Data was collected at la Fe University Hospital in Valencia. Obstetric and immunohematologic data from pregnant women controlled in the Obstetrics Department from January 2011 to January 2016 were reviewed. Follow-up of newborns affected was also collected. Results: During the study period, 27609 pregnant women (23215 Rh (D) positive and 4394 Rh (D) negative) were controlled in the obstetric service of the hospital. Of these, 176 (0.63 %) had some clinically significant RBC alloantibody and 30 women (0.1 %) had more than 1 alloantibody. The antigens most often found were anti-D for Rh (D) negative women, and anti-E for Rh (D) positive women. In thirteen patients requiring IUT, the antibody pattern was as follows: 7 patients with anti-D, 4 anti-D combined with anti-C, 1 anti-K, 1 anti-c combined with anti-E. Plasmapheresis was also performed to one patient. Discussion: Anti-D remains the most frequent antibody in pregnant women and produces the most severe HDN in our area. Since it is the only alloimmunization that can be prevented, an effort to administrate prophylaxis to all RhD negative pregnant women population is mandatory. Plasmapheresis can be useful, as adjuvant treatment in those cases of severe HDN to reduce the alloantibody titer and consequently ITU needs
Haemolytic Disease of the Newborn
KYAMC Journal
Background: Immune-mediated haemolytic disease of the newborn refers to a specific category of haemolytic anaemia that results from transplacental passage of IgG antibodies from a pre-sensitized mother to her fetus in utero. This occurs due to blood group incompatibility between the mother and the fetus. The clinical presentation covers a wide spectrum spanning from still births and erythroblastosis fetalis as well as infants born with only mild haemolysis to those having severe anaemia snd severe indirect hyperbilirubinaemia followed by hydrops.Objective: We describe the journey of a Rh-D negative mother who endured through six pregnancies in order to have a healthy baby.Conclusion: To highlight the importance of blood grouping and Rh typing during the first antenatal visit and subsequent monitoring of antibody titers, especially in a mother who is Rh-D negative. KYAMC Journal Vol. 14, No. 01, April 2023: 54-56
Neonatal haemolytic disease with co-existing Anti-D and Anti-C antibodies: an unusual experience
Journal of Pakistan Medical Association, 2022
Neonatal haemolytic disease in the newborn remains of prime importance for paediatricians due to high perinatal morbidity and mortality rates. The Rh antigen family comprises several different antigens, out of which, D antigen incompatibility is well known for causing severe haemolytic disease in the foetus. Although the current literature shows anomalous cases where coexisting non-D-Rh and D-Rh antigens are the causative agents, there is very little information regarding post-natal outcomes in neonates bearing two different incompatibilities simultaneously. Herein, we discuss an unusual case of anti-D as well as anti-C antibodies (non-D-Rh) in a male neonate born to a Rh-negative mother, who developed jaundice and haemolysis in post-natal life. The neonate underwent exchange transfusion and photo therapy due to raised serum bilirubin levels, supplemented with repeated blood transfusions, intravenous immunoglobulin therapy, and immunosuppressive therapy. He responded well to the management and was later discharged from the hospital. Long-term follow-up revealed no side-effects.
An Unusual Case of Hemolytic Disease of Newborn Due to ABO and Rh Isoimmunization
Cureus, 2020
Anti-D is the most common cause of hemolytic disease of the newborn (HDN) in the developing countries even after the introduction of anti-D immunoprophylaxis. Still, ABO incompatibility and other alloantibodies against minor blood group antigens have emerged as significant causes of HDN. Moreover, ABO incompatibility acts as a protective barrier to the expression of Rh isoimmunization. Here we are presenting a case of HDN where both Rh and ABO incompatibility co-existed with their manifestations in a B positive neonate born to an O positive mother. Use of appropriate elution technique can aid in the diagnosis of such cases. Hence, antenatal screening of all mothers irrespective of their Rh D status can help in early diagnosis and proper management that can decrease the neonatal morbidity and mortality.
2019
Background: ABO/Rh incompatibilities are common causes of hemolytic disease of newborn. Alloimmunization due to minor RBC antigens may also cause severe hemolysis and hyperbilirubinemia necessitating exchange transfusion in the early neonatal period. Case Presentation: Here we report a rare case (first such report to our knowledge in Iran) of severe hemolytic disease of the newborn due to anti-Rh17 antibody (an antibody to the RhCc/ Ee antigen protein) in a newborn with maternal blood group B Rh D-. Conclusion: Presenting this case would improve the insight and knowledge about managing severe hemolytic anemia due to minor group alloantibodies postnatally, and highlight the importance of prenatal surveillance and diagnosis for the optimal management of alloimmune hemolytic disease.