Uneventful transfusion of Jr(a+) red cells in the presence of anti-Jra.

Fatal hemolytic disease of the fetus and newborn caused by anti-Jra antibody: A case report and literature review

“…The main feature of previous reports [2,6,7,[10][11][12][13][14][15][16][17], including severe cases, is multiparity. In our case, immunization might have occurred during a previous abortion.…”

“…A Jr a -negative patient with anti-Jr a antibody who was transfused with Jr a -positive RBCs showed no severe complication [5]. This diversity in clinical manifestations might be because of the different in vivo activity of the anti-Jr a antibody, and antibody subclasses can provide one possible explanation for this difference [6,7,17]. In IgG subclass analysis for anti-Jr a antibodies, IgG1, associated with complement activation, was the predominant clone [6].…”

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

“…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 .…”

“…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 . The remaining literature on Jr a has focused on the use of in vivo and in vitro assays and their ability to assess the clinical significance of anti‐Jr a 16‐20 .…”

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.…”