Hemolytic Disease of the Newborn Due to Anti-C and Anti-G Masquerading as Anti-D

Yesus, Yohannes W.; Akhter, Jeanette E.

doi:10.1093/ajcp/84.6.769

Cited by 16 publications

(14 citation statements)

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“…Double elution procedures have been used to demonstrate that anti‐G was present in 30% of sera containing anti‐D+C, and that anti‐G was the predominant antibody in 6% of cases (Issitt & Tessel, 1981). Anti‐G alone has been associated with HDN (Yesus & Akhter, 1985; Hadley et al ., 1996).…”

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confidence: 99%

Identification and quantification of anti‐D, ‐C and ‐G in alloimmunized pregnant women

Maley¹,

Babb²,

Chapman³

et al. 2001

Transfusion Medicine

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Our objectives were to investigate possible overestimation of maternal anti-D due to co-existing anti-C and/or anti-G, and to confirm the presence of anti-D in plasma presumed to contain anti-D+C. We investigated 96 samples (from 22 antenatal patients and 74 blood donors) initially identified as containing anti-D+C using routine investigation procedures. Anti-D quantification was performed using an Astoria Pacific International 300 (API 300) continuous flow analyser with R1R1 and R2R2 reagent red cells. Where possible, samples were tested manually using a rare D+, C-, G- cell, to confirm the presence of anti-D. Fifty-two of 96 samples (11/22 antenatal patients and 41/74 blood donors) gave >50% higher anti-D quantification results with R1R1 cells than with R2R2 cells. Anti-D was not detected using manual techniques in 16 of 73 samples tested (10/22 antenatal patients and 6/51 blood donors). Anti-D quantification using R1R1 reagent red cells may cause inaccurate estimation of anti-D levels, when anti-C and/or anti-G are present. Indeed, a significant number of cases, where apparent anti-D+C is identified, may contain only anti-C+G and lack an anti-D component. This may in turn lead to a failure to administer prophylactic anti-D immunoglobulin to RhD negative patients in cases where anti-D is not present, putting these patients at risk from immunization with possible consequences to future pregnancies.

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confidence: 99%

Identification and quantification of anti‐D, ‐C and ‐G in alloimmunized pregnant women

Maley¹,

Babb²,

Chapman³

et al. 2001

Transfusion Medicine

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“…5 In another study, an Rh(D) negative woman with a history of multiple transfusions of Rh(D) negative blood in the past was thought to have anti-D and anti-C. Prenatal workup revealed that the patient had an anti-G rather than an anti-D. At 32.5 weeks of gestation, the mother delivered an affected fetus with moderately severe HDN. 6 We conclude that even though hemolytic HDN due to anti-G is very uncommon, it should still be considered when more reactivity is observed with C(+)D(-) than with the C(-)D(+) antibody screening red blood cells. …”

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confidence: 79%

Is It Really Anti-D and Anti-C or Is It Anti-G?

Rikabi

Dunn-Albanasse

Krugh

et al. 2003

Laboratory Medicine

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“…mentioned isolated anti-G causing moderate HDFN in an infant with hyperbilirubinemia requiring a prolonged stay in the hospital for phototherapy. [2] In another report, moderately severe HDFN was reported in a RhD-negative woman with anti-G.[11] All these cases showed the evidence of HDFN due to anti-G. Thus, it is important to correctly identify the specificity of the antibodies during pregnancy in patients who have initial antibody testing showed concurrent anti-C and anti-D antibodies.…”

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confidence: 99%

Anti-G with concomitant anti-C and anti-D: A case report in a pregnant woman

Yousuf

Mustafa

et al. 2017

Asian J Transfus Sci

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The G antigen of Rh blood group system is present in almost all D-positive or C-positive red cells but absent from red cells lacking D and C antigens. The differentiation of anti-D and anti-C from anti-G is not necessary for routine transfusion; however, during pregnancy, it is important because anti-G can masquerade as anti-D and anti-C with initial antibody testing. The false presence of anti-D will exclude the patient from receiving anti-D immunoglobulin (RhIG) when the patient actually is a candidate for RhIG prophylaxis. Moreover, patients with positive anti-D or anti-G are at risk of developing hemolytic disease of the fetus and newborn and need close monitoring. Thus, proper identification allows the clinicians to manage patients properly. This case report highlights a rare case of anti-G together with anti-D and anti-C in a pregnant woman. This report disseminates knowledge on identification of anti-G and its importance in pregnant women.

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Hemolytic Disease of the Newborn Due to Anti-C and Anti-G Masquerading as Anti-D

Cited by 16 publications

References 0 publications

Identification and quantification of anti‐D, ‐C and ‐G in alloimmunized pregnant women

Identification and quantification of anti‐D, ‐C and ‐G in alloimmunized pregnant women

Is It Really Anti-D and Anti-C or Is It Anti-G?

Anti-G with concomitant anti-C and anti-D: A case report in a pregnant woman

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