A study of maternal blood samples from 280,000 pregnancies in an 8-year period has shown 38 examples of anti-C (without anti-D) sensitization. This frequency (0.14/1000 pregnancies) was lower than that previously found for anti-c (0.63/1000 pregnancies) and for anti-D (2.55/1000 pregnancies). Although most of the 38 babies born to mothers with anti-C were unaffected by haemolytic disease of the newborn and none was anaemic at birth, two required exchange transfusion for hyperbilirubinaemia and one a top-up transfusion. Five cord blood samples had a positive direct antiglobulin test.
In 5 patients of phenotype ccDEe or ccDEE, the transfusion of 2--14 U of C-positive blood was folloued 5--9 days later by haemoglobinuria lasting 2--4 days. Anti-C was the only antibody present in all 5 cases but was always of low titre; with CC cells the maximum titre recorded with the indirect antiglobulin test was 8 and with the agglutination of enzyme-treated cells, 128. The discordance between the weakness of the antibody in vivo and the amount of haemoglobin released intravascularly is surprising but may be related to the type of IgG molecule of which anti-C is composed.
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