Combined Anti e and Anti C Rh Isoimmunisation and Severe Hyperbilirubinemia

Sharma, Deepak; Dannapuneni, Nivedita; Murki, Srinivas; Pratap, Tejo

doi:10.1007/s12098-014-1662-6

Cited by 10 publications

(4 citation statements)

References 5 publications

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“…There are few case reports regarding anti‐C alloimmunization alone . It has more often been reported that anti‐C can be additive to the hemolytic effects of anti‐D and is more often associated with severe outcomes in compound antibodies or in pregnancies affected by multiple antibodies . This was the case in our study: of the pregnancies affected by anti‐C alone, 20% reached the critical titer compared with 84.6% when anti‐C occurred with anti‐D.…”

Section: Discussionsupporting

confidence: 47%

How clinically important are non‐D Rh antibodies?

Healsmith

Savoia

Kane

2019

Acta Obstet Gynecol Scand

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Introduction The advent of RhD immunoglobulin prophylaxis to prevent maternal RhD alloimmunization has reduced the incidence of this condition and its associated poor outcomes. Consequently, non‐D Rh antibodies now account for a greater proportion of alloimmunized pregnancies. These antibodies have been the subject of comparatively little research. This study investigated the incidence and clinical outcome of pregnancies affected by non‐D Rh alloimmunization at an Australian tertiary maternity service. Material and methods This was a retrospective study of all pregnancies with non‐D Rh antibodies (namely anti‐C, ‐E, ‐c, ‐e, ‐Cw as well as the compound antibodies anti‐CD, ‐cE and ‐ce) managed at the Royal Women's Hospital, Victoria, Australia, from 2009 to 2013 inclusive. Information collected included maternal demographics, details of the antibodies, course of the pregnancy and neonatal outcomes. Results During the study period, 115 non‐D Rh alloimmunized pregnancies were identified in 102 mothers. Forty‐nine pregnancies reached the critical titer (> 16) from non‐D Rh alone and 11 fetuses received intrauterine red blood cell transfusion. Labor was induced or cesarean section performed in 38 cases. Forty‐three neonates were admitted to the special care nursery and 59 received phototherapy. Nine received treatment for anemia and 10 neonates received intravenous immunoglobulin. Conclusions Non‐D Rh alloimmunization is a relatively uncommon complication of pregnancy, occurring in only .33% of pregnancies in the study period. It can lead to significant fetal/neonatal morbidity (and may lead to mortality). The most severe outcomes (including perinatal deaths) were mostly associated with the compound antibodies anti‐CD and anti‐cE, or a non‐D Rh antibody in conjunction with anti‐D.

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Section: Discussionsupporting

confidence: 47%

How clinically important are non‐D Rh antibodies?

Healsmith

Savoia

Kane

2019

Acta Obstet Gynecol Scand

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“…18 Very few cases of HDFN due to anti-e are reported in the literature, and there are fewer cases in which other antibodies are also present. 19 Because the mother also lacks C, HDFN could be produced by anti-C that was present but masked by the anti-e. This possibility was addressed by the repeat testing to exclude anti-C performed during antibody identification studies.…”

Section: Discussionmentioning

confidence: 99%

Severe perinatal hemolytic disease due to anti-e

et al. 2021

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Maternal antibody-mediated fetal red blood cell destruction secondary to non-D Rh system antibodies is a significant cause of hemolytic disease of the fetus and newborn. Here, we report a rare case of severe perinatal hemolytic disease associated with maternal antibody to the e antigen. In addition to severe anemia, the infant developed hyperbilirubinemia. Resolution of the infant’s anemia and hyperbilirubinemia occurred after treatment with phototherapy, intravenous immunoglobulin, and transfusion.

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“…Sharma et al 6 and Thakral et al 7 reported cases of HDN because of combined anti-c/anti-E antibody in Rh (D) positive mothers but only few cases of HDN were reported from India due to anti-E antibody. Comparison table has been made of previous cases with index case (Table 2).…”

Section: Discussionmentioning

confidence: 99%

Severe Hemolytic Disease of Newborn Due to Alloimmune Anti-E Antibodies: A Case Report

Jarjapu

Panigrahy

Jamalpuri

et al. 2021

Journal of Neonatology

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Hemolytic disease in the newborn (HDN) as a cause of early jaundice is mostly due to Rh (D), ABO incompatibility, and rarely due to other minor blood group incompatibility. We report case of Rh anti-E isoimmunization presenting as significant unconjugated jaundice within the 24 h of life. Baby presented with severe jaundice and anemia on day 1 of life. Baby was treated with intensive phototherapy, double volume exchange transfusion (DVET), and intravenous immunoglobulins. On evaluation, both mother and baby had O positive (Rh) blood group; however, the infant showed evidence of severe hemolysis. Positive direct Coombs test (DCT) and 11 cell antibody panel showed anti-E antibodies. This case highlights the importance of early identification and evaluation of HDN in the absence of Rh(D) and ABO incompatibility and possibility of severe hemolysis in Rh anti-E isoimmunization needing DVET.

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Combined Anti e and Anti C Rh Isoimmunisation and Severe Hyperbilirubinemia

Cited by 10 publications

References 5 publications

How clinically important are non‐D Rh antibodies?

How clinically important are non‐D Rh antibodies?

Severe perinatal hemolytic disease due to anti-e

Severe Hemolytic Disease of Newborn Due to Alloimmune Anti-E Antibodies: A Case Report

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