Hemolytic Disease of the Newborn Due to Anti-c Isoimmunization: A Case Report

Sheeladevi, CS; Satish, Suchitha; Manjunath, GV; Murthy, Srinivas

doi:10.1007/s12288-012-0159-6

Cited by 15 publications

(12 citation statements)

References 5 publications

(9 reference statements)

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“…22 A case of HDFN due to anti-C in Rh-D positive mother has also been reported. 23 Similar incidence has been seen in another study also. 10 We have not observed any of these antibodies except anti-M (4.5%) of the other types of antibodies that are occasionally associated with HDFN (anti Jk a , Jk b , S, etc.,).…”

Section: Discussionsupporting

confidence: 86%

Prevalence of “unexpected antibodies” in the antenatal women attending the Government Maternity Hospital, Tirupati

et al. 2015

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Background: All antibodies to red cell antigens, other than naturally occurring anti-A and anti-B are considered unexpected. They can be either alloantibodies or auto antibodies. In pregnant women, these antibodies may cross the placenta and cause haemolytic disease of the foetus and newborn (HDFN). Timely detection of such antibodies in antenatal women is essential for early management of HDFN. Methods: A prospective cross-sectional study was carried out on 2060 multiparous pregnant women attending the Government Maternity Hospital, Tirupati to detect prevalence of unexpected antibodies. The women were grouped and typed for ABO and rhesus (Rh) D antigens by tube method and screened for alloantibodies by column agglutination technology. The medical and detailed obstetric history of these women were reviewed. Results: The overall prevalence of alloantibodies was 1.1%. There was a statistically significant difference between alloimmunization rates in the Rh D-antigen negative and D-antigen positive women (12.8% versus 0.3%). The antibodies detected in this study were, anti-D (63.8%), anti-D+C (13.7%), anti-C, anti-E, anti-M, anti-Le a , and anti-Le b (4.5% each). Anti-D contributed to 77.3% of total alloimmunization in this study. Conclusions:In spite of the introduction of prophylactic Rh-immunoglobulin, anti-D (77.3%) is still a common antibody identified in the antenatal women of our region. In developing countries like India, universal antenatal antibody screening, though desirable may not be justified at present as the cost and infrastructure required would be immense. However, it is necessary to impose properly formulated protocols to screen at least the pregnant women with adverse obstetric history.

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Section: Discussionsupporting

confidence: 86%

Prevalence of “unexpected antibodies” in the antenatal women attending the Government Maternity Hospital, Tirupati

et al. 2015

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“…1b), the most frequent RhD negative haplotype is dec [14,39,40], except in Moroccans where haplotype deC is more common. Among RhD positive haplotypes, the ancestral haplotype Dec [39,40] is the most frequent in Africans, whereas in non-African populations haplotype DeC is found at higher frequencies [41]. The dEC haplotype was not found in our population dataset, and DEC was only found at low frequencies in the CHB population.…”

Section: Rhd and Rhce Phenotypes Genotypes And Haplotypescontrasting

confidence: 57%

Sequence diversity of the Rh blood group system in Basques

et al. 2018

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Basques show specific cultural, demographic, and genetic characteristics that have placed them as an isolated and unique population within Europe, such as their non-Indo-European language, Euskara. They have historically lived along the Western Pyrenees, between Spain and France, in one of the most important European glacial refugia during the Last Glacial Maximum. The most striking genetic characteristic is their highest frequency of the RhD blood group negative allele, a variant related to the hemolytic disease of the newborn. Both demographic and adaptive processes have been suggested as possible causes of the high frequency of RhD negative in Basques, but neither hypothesis has been clearly demonstrated. While previous studies on the Rh system in Basques have been mostly focused on serological and genotyping diversity, in this work we analyze genotyping and next generation sequencing data in order to provide a general framework of the genetic scenario of the system in Basques. In particular, we genotyped the most relevant variants of the system (D/d, E/e, and C/c), and sequenced three ~6 kb flanking regions surrounding the Rh genes in Basques and also in other populations for comparison. Our results are in agreement with previous studies, with Basques presenting the highest frequency of the RHD deletion (47.2%). Haplotype analyses of D/d, E/e, and C/c variants confirmed an association between the RhC allele, previously suggested to be under positive selection, and the RhD positive variant in non-sub-Saharan populations, including Basques. We also found extreme differentiation for the C/c variant when comparing sub-Saharan to non-sub-Saharan populations.

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“…Our study had similar findings, with two of 15 cases receiving treatment for anemia, and both receiving intravenous immunoglobulin (500 mg/kg IV, then repeated 12 hours later). However, there have also been studies and a case report suggesting anti‐c can cause more severe HDFN.…”

Section: Discussionmentioning

confidence: 99%

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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Hemolytic Disease of the Newborn Due to Anti-c Isoimmunization: A Case Report

Cited by 15 publications

References 5 publications

Prevalence of “unexpected antibodies” in the antenatal women attending the Government Maternity Hospital, Tirupati

Prevalence of “unexpected antibodies” in the antenatal women attending the Government Maternity Hospital, Tirupati

Sequence diversity of the Rh blood group system in Basques

How clinically important are non‐D Rh antibodies?

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