Anti-S antibodies: an unusual cause of haemolytic disease of the fetus and newborn (HDFN)

Pitan, C; Syed, Azhar Talha; Murphy, William F.; Akinlabi, Oluwafemi; Finan, Alan

doi:10.1136/bcr-2012-006547

Cited by 8 publications

(5 citation statements)

References 11 publications

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“…Tel. : +44 (0)1872 252500; e-mail: isullivan@nhs.net HDFN due to anti-S is rare, but there are published case reports of HDFN (Levine et al, 1952;Mayne et al, 1990;Parsh, 2000;Dajak et al, 2011;Yousuf et al, 2012;Pitan et al, 2013). And within our hospital, we have had a severe case of HDFN due to anti-S requiring exchange transfusion, which we present here.…”

Section: Dear Sirmentioning

confidence: 72%

Reply: Prevalence of maternal alloantibodies in a large teaching hospital and their impact on outcomes of fetuses/neonates

Sullivan

2018

Transfusion Medicine

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In the report by Ainley et al. 'Prevalence of maternal alloantibodies in a large teaching hospital and their impact on outcomes of fetuses/neonates' (2017), we recognise the significance of the dataset presented by the authors. This will be of great use to many, particularly those investigating the use of intraoperative cell salvage in Obstetrics and the risk of alloimmunisation.We had previously undertaken a similar, albeit much smaller, data collection, which was not as thorough. Our alloimmunisation rates were approximately 0·4%. Of this, anti-D accounted for 22%, anti-c 9%, anti-K 15%, other Rh antibodies 42% and others (such as Fy, Jk, S) 30%. Some patients had multiple antibodies. Regarding the reasons of sensitisation, 39% were due to a previous pregnancy and 11% due to a transfusion. Of the remainder, there was insufficient history to confirm whether the antibodies formed were from transfusion or pregnancy. To determine the cause of sensitisation in these remaining cases, a review of the patient's notes would be required something, which was not conducted at the time. As such, our dataset is not complete, and we therefore welcome the report by Ainley.Also in the same article, we note that they have reclassified anti-S into the same group (3) as non-clinically significant antibodies, such as anti-M, anti-N, anti-Kpa, anti-Lea and anti-Leb. However, we feel that anti-S should be taken more seriously because, despite being a relatively infrequent cause of haemolytic disease of the fetus and newborn (HDFN), it can be significant.Anti-S is predominately of immunoglobulin G (IgG) and can therefore cross the placenta and has been implicated in both haemolytic transfusion reactions (HTRs) and severe or even fatal HDFN.

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Section: Dear Sirmentioning

confidence: 72%

Reply: Prevalence of maternal alloantibodies in a large teaching hospital and their impact on outcomes of fetuses/neonates

Sullivan

2018

Transfusion Medicine

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“…On the one hand, fetal or neonatal alloimmune disorders caused by anti-Jk a , anti-Jk b , and anti-S can result in fetal or neonatal death, and the only treatment is systemic blood exchange. 18 , 19 Therefore, it is important to know the frequency distribution of local blood groups, which will guide the preparation of blood in the event of alloimmune disorders of fetuses and neonates. On the other hand, the number of samples in the blood bank is huge.…”

Section: Introductionmentioning

confidence: 99%

Non-invasive prenatal testing for fetal Ss, Kidd, and CTL2 blood group prediction by multiplex digital droplet PCR

Wang

Chu

Chen

et al. 2023

Therapeutic Advances in Hematology

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Background: Some blood groups, such as S and s blood groups in the MNS blood group system, and Kidd and CTL2 blood group systems, can cause severe fetal and newborn alloimmune disorders. Non-invasive prenatal testing (NIPT) to predict fetal blood groups and knowledge of local blood group gene frequency are both important for pregnancy management decisions. Droplet digital PCR (ddPCR) has high specificity and sensitivity in detecting fetal single nucleotide variation. Objectives: The objective is to predict fetal Ss, Kidd, and CTL2 blood groups using multiplex ddPCR. The gene frequencies of three blood groups were detected by ddPCR in northwest China. Design: This is a prospective study. Methods: Cell-free fetal DNA isolated from 26 healthy single pregnant women at different gestational stages was tested with QX200 Droplet Digital PCR. Results were compared with fetal genotypes. DNA samples purified from 20 blood pools containing a total of 1000 donors in northwest China were subjected to ddPCR to detect the gene frequency of three blood groups. Results: Ss, Kidd, and CTL2 blood groups of 26 pregnant fetuses were accurately detected by multiplex ddPCR. The multiplex ddPCR results were consistent with the Sanger sequencing results of 26 fetal blood samples after birth. The gene frequencies of the three blood groups detected by ddPCR were 9.30% for S, 90.70% for s, 48.43% for Jka, 51.57% for Jkb, 66.57% for HNA-3A, and 33.43% for HNA-3B. Conclusions: It is reliable to predict fetal Ss, Kidd, and CTL2 blood groups by multiplex ddPCR. Meanwhile, we designed a simple and efficient method for inferring the gene frequency of three blood groups based on ddPCR.

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“…HDN, also known as erythroblastosis foetus, occurs when foetal RBC inherited antigen that the mother lacks crosses the placenta and stimulates maternal antibody production. HDN can occur both in vitro (in utero) and ex vitro (right after delivery) resulting in the formation of maternal immunoglobulin, especially immunoglobulin G (IgG) antibodies which are able to cross the placenta into the foetal circulation (2). Following the escape of the maternal antibody into the foetus circulation, the foetal RBCs are attacked and haemolysed (3), which might cause hydrops foetalis, anaemia with reticulocytosis and hyperbilirubinemia (4).…”

Section: Introductionmentioning

confidence: 99%

Haemolytic of Newborn Disease-Related Red Blood Cell Alloantibodies

Nahendran

Budin²,

Saat³

et al. 2022

Jurnal Teknologi

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Red cell alloimmunisation in pregnancy may result in haemolytic disease of the foetus and newborn (HDN). During pregnancy, there are possibilities of the foetal antigen being exposed to the mother’s circulation, thereby leading to the production of antibodies. The immunoglobulin G (IgG) antibodies from the mother pass through the maternal surface placenta, which is then sensitised and obstructs the formation of foetal red blood cells (RBCs). This review discusses the presence of variance alloantibodies during pregnancy, as well as the consequences of HDN and its management. This review revealed that ABO incompatibility is the most common cause of alloimmunisation in pregnancy. The Rh system (anti-D and -E) are the most common alloantibodies found in pregnant women, followed by other alloantibodies such as Kell, Duffy, Kidd and MNSs. Hyperbilirunemia (increased bilirubin levels) is commonly seen in neonatal jaundice due to HDN and it is usually manageable using the phototherapy method. Nevertheless, the clinical significance of alloantibodies can cause complications such as anaemia, and in some extreme cases, kernicterus might require a blood exchange transfusion.

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Anti-S antibodies: an unusual cause of haemolytic disease of the fetus and newborn (HDFN)

Cited by 8 publications

References 11 publications

Reply: Prevalence of maternal alloantibodies in a large teaching hospital and their impact on outcomes of fetuses/neonates

Reply: Prevalence of maternal alloantibodies in a large teaching hospital and their impact on outcomes of fetuses/neonates

Non-invasive prenatal testing for fetal Ss, Kidd, and CTL2 blood group prediction by multiplex digital droplet PCR

Haemolytic of Newborn Disease-Related Red Blood Cell Alloantibodies

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