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Allo-anti-M often has an immunoglobulin G (IgG) component but is rarely clinically significant. We report a case of hemolytic disease of the fetus and newborn along with prolonged anemia in newborn twins that persisted for up to 70 days postbirth. The aim was to diagnose and successfully manage hemolytic disease of newborn (HDN) due to maternal alloimmunization. Direct antiglobulin test (DAT), antigen typing, irregular antibody screening and identification were done by polyspecific antihuman globulin cards and standard tube method. At presentation, the newborn twins (T1, T2) had HDN with resultant low reticulocyte count and prolonged anemia, which continued for up to 70 days of life. Blood group of the twins and the mother was O RhD positive. DAT of the both newborns at birth was negative. Anti-M was detected in mothers as well as newborns. Type of antibody in mother was IgG and IgM type whereas in twins it was IgG type only. M antigen negative blood was transfused thrice to twin-1 and twice to twin-2. Recurring reduction of the hematocrit along with low reticulocyte count and normal other cell line indicated a pure red cell aplastic state. Anti-M is capable of causing HDN as well as prolonged anemia (red cell aplasia) due to its ability to destroy the erythroid precursor cells. Newborns with anemia should be evaluated for all the possible causes to establish a diagnosis and its efficient management. Mother should be closely monitored for future pregnancies as well.

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Methemoglobinemia, an altered state of hemoglobin resulting in impaired oxygen delivery to the tissues can be congenital or following exposure/ingestion of various oxidant drugs or toxins. One of the earliest signs of methemoglobinemia is generalized cyanosis not improved on oxygen supplementation and presence of normal PO on acid blood-gas analysis. Here, we report two cases of acquired methemoglobinemia following poisoning and our experience of managing them with automated therapeutic red cell exchange.

Autologous platelet biomaterials represent a key source of cytokines and growth factors extensively used for clinical and surgical applications involving tissue regeneration; wound healing and tissue repair. In this communication we discuss the growth factors released by activated platelet rich plasma (PRP) and platelet rich fibrin (PRF) releasate. Our study highlights that significantly higher growth factors (TGF-ß1) are released by activated PRP as compared to releasate of PRF. The various growth factors released by both platelet products are significantly higher than the baseline concentration in the whole blood and have different bio-mechanism hence should be individualized as per the clinical indication.