The ability of cellular assays to predict the necessity for cordocenteses in pregnancies at risk of haemolytic disease of the newborn

2000

Immunohematology

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Hemolytic disease of the newborn (HDN) due to anti-Hr 0 antibody is typically severe and often fatal. We report a case of moderate HDN due to anti-Hr 0 in a woman with the D--/D--phenotype. A 33-yearold woman delivered her second child who was mildly jaundiced. The highest level of bilirubin was 26.1 mg/dL on the third day postpartum and the hemoglobin concentration was 14.0 g/dL. The newborn recovered after phototherapy and no mental retardation was noticed after 1 year of follow up. An exchange transfusion was excluded due to the lack of a compatible donor and the physical condition of the mother precluded blood donation. The maternal RBCs were D+C-c-E-e-; only G and Rh29 of the Rh system were expressed. Thus, her probable phenotype was D--/D--. Her alloantibody was identified as anti-Hr 0 (anti-Rh17) as it reacted with all red blood cells (RBCs) but not her own, other D---RBCs, and Rh null RBCs. The results of the antibody titer (64) and activity in a chemiluminescense test (CLT; 34%) were consistent with a moderate HDN. Family studies were negative for the D--/D--phenotype and consanguinity was not proved. This is the first described case of moderate HDN due to anti-Hr 0 . The result of antibody activity in the CLT might be helpful in predicting the severity of HDN in other rare HDN cases.

Section: Discussionmentioning

confidence: 93%

Moderate hemolytic disease of the newborn due to anti-Hr₀ in a mother with the D––/D–– phenotype

Lenkiewicz

2000

Immunohematology

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“…In her third pregnancy (6 years later), anti‐Co a was detected in the tenth week of gestation, the titre increased gradually from 8 to 128 by the 22nd week (Table 1). At the same time, the result of the functional activity of the antibody, evaluated by the chemiluminescence test (CLT) (Hadley et al , 1998; Zupanska et al , 2001) with Co(a+) cells, was weakly positive (8.8% compared with the negative control, i.e. with Co(a−) cells).…”

Section: Case History and Serological Examinationsmentioning

confidence: 99%

Anti‐Co^a implicated in severe haemolytic disease of the foetus and newborn

Michalewska

Wielgoś

et al. 2008

Transfusion Medicine

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BACKGROUND Haemolytic disease of foetus and newborn (HDFN) is triggered by enhanced destruction of red blood cell due to immune-mediated destruction, intrinsic abnormalities, acquired aberrations, etc. Lifespan of infant's erythrocytes are shortened by the action of placentally transferred maternal antibodies in immune-mediated HDFN. The aim of this study was to identify the frequency of maternal antibodies in neonates with hyperbilirubinaemia. Settings and Design-This was a cross-sectional study in neonates admitted to neonatal intensive care unit (NICU). Setting for the research was Dept. of Transfusion Medicine and Neonatology division of Sree Avittom Thirunal Hospital for women and children attached to Govt. Medical College, Trivandrum.

“…The antibody was immunoglobulin G3 (IgG3) alone (ID‐Card IgG1/IgG3, DiaMed, Cressier, Switzerland) and failed to bind complement. Its functional activity, evaluated by the chemiluminescence test (CLT), was 4% of our standard positive control, suggesting a very mild haemolytic disease of the fetus and newborn (HDFN) (Hadley et al ., 1991; Żupańska et al ., 2001).…”

Section: Case History and Serological Investigationsmentioning

confidence: 99%

The first example of anti‐Diego^b found in a Polish woman with the Di(a+b–) phenotype and haemolytic disease of the newborn not requiring treatment

Lenkiewicz

2003

Transfusion Medicine

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All pregnant women with anti-Diegob (anti-Dib) described so far were non-Caucasians. We present the case of a Polish Di(a+b-) woman with anti-Dib, which did not bind complement, was immunoglobulin G3 (IgG3) alone and had very low functional activity. She delivered a Di(a+b+) infant with a positive direct antiglobulin test and the antibody in his serum but very mild haemolytic disease. Both parents of the pregnant woman were Di(a+b+), so were all her three children. The whole family have been living in a small village in southeastern Poland for a long time. The rare Diego phenotypes, found now and previously in Poland, suggest gene admixture introduced as a result of Poland being invaded by Mongolian-background Tatars during the past centuries.