Case report, anti‐Jr^a

Clinical significance of anti‐Jra: report of two cases and review of the literature

“…A review of the literature indicates that anti‐Jr a may be clinically significant because it has been implicated in cases of HDN and transfusion‐related hemolysis. When HDN occurred, all reported cases were mild to moderate in intensity and often required no treatment beyond phototherapy 2‐11 . Rare cases of hemolysis associated with transfusion have been reported, mostly as delayed hemolytic transfusion reactions 13‐15 .…”

“…Also reported are cases where Jr a antibodies have demonstrated a lack of clinically evident hemolysis in individuals who have received Jr(a+) RBCs 12 . Bacon and others reported anti‐Jr a in a primigravida woman with no history of transfusion who received 3 units of least‐incompatible whole blood due to complications at the time of delivery 3 . Her anti‐Jr a titer rose from 32 (before transfusion) to 2048 (20 days after transfusion) and later fell to 64 (35 days after transfusion).…”

“…Over the past 30 years, a handful of additional Jr a antibody case reports have been published. The majority of these cases involved Jr a antibodies in gravid women, highlighting their potential to cause HDN 2‐11 . A few additional cases reported on anti‐Jr a in the setting of incompatible transfusions 12‐15 .…”

Junior and Langereis Blood Group Systems

“…Anti -Jr a is a dangerous antibody in pregnancy and has been implicated in severe and fatal HDFN [11,12,19,22] , although in other pregnancies with maternal anti -Jr a indications of HDFN have been no more than a positive DAT on cord cells or mild neonatal jaundice [5,16,17,20,25] .…”

Case report: massive postpartum transfusion of Jr(a+) red cells in the presence of anti-Jra

“…Jr(a+) RBCs have been transfused to individuals with anti-Jr a without incident. [3][4][5] On the other hand, there exist in the literature a dozen or so reports highlighting the ability of anti-Jr a to cause both mild to moderate HDN and delayed hemolytic transfusion reactions. 6 The typical hemolytic reaction associated with anti-Jr a is delayed, extravascular, and self-limited, and the decreasing Hct is usually accompanied by transiently increased antibody titers.…”