Rh iso-immunisation is prevalent in many underdeveloped countries. Severe haemolytic anaemia with or without hydrops fetalis, dangerous level of haemolytic unconjugated bilirubin and imminent bilirubin encephalopathy are the hallmarks of haemolytic disease of the newborn. The investigative protocols and efficient management of this entity are adequately described in literature. An unusual manifestation of this disease with severe hepatocellular damage and conjugated hyperbilirubinemia was noticed in a neonate. The literature has been reviewed and the specific symptom complex has been attributed to 'syndrome of hepatocellular damage', which is a rare accompaniment of haemolytic disease of the newborn. Attempts have been made to describe the syndrome in detail, with latest reference regarding complete workup and management. Few useful tips for prevention of the disease in a community background have been suggested.

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Undifferentiated connective tissue disease is an overlap syndrome in which the features of more than one disease is present but their complete diagnosis is lacking. We are presenting an 11year child with fever, arthritis, polyserositis, myalgia, nephritis, sclerodactyly with positive anti-dsDNA and anti-Smith antibody. She improved with prednisolone and cyclophosphamide.

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