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

2021 ◽  
pp. 097321792110563
Author(s):  
Jarjapu Kireeti ◽  
Nalinikanta Panigrahy ◽  
Vijayanad Jamalpuri ◽  
Surekha A. Devi
Keyword(s):  
Blood Group ◽  
Intravenous Immunoglobulins ◽  
Coombs Test ◽  
Hemolytic Disease ◽  
Abo Incompatibility ◽  
Cell Antibody ◽  
Antibody Panel ◽  
Severe Jaundice ◽  
Positive Direct ◽  
Rh Blood Group

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.

scholarly journals A Complete Review Article on ABC of Blood Groups

2014 ◽  
Vol 2 (1) ◽  
Author(s):  
Purna Singh A ◽  
Shivanand S Rathod ◽  
Praveen K Kodumuru ◽  
Desai JM ◽  
Vaishali Nagose
Keyword(s):  
Blood Group ◽  
Blood Groups ◽  
Hemolytic Disease ◽  
Transfusion Therapy ◽  
Abo Incompatibility ◽  
Grouping Systems ◽  
Rh Blood Group ◽  
Blood Grouping ◽  
Increased Susceptibility

ABO and Rh blood group systems are the most important blood grouping systems from clinical aspect. Determination of blood group is important for blood transfusion therapy, medico-legal purposes, organ transplantation, settlement of paternity disputes etc. Nearly 25 types of blood groups are present. ABO incompatibility between mother and fetus may produce infertility or hemolytic disease of the new born, and persons of certain blood groups have an increased susceptibility to peptic ulcer or gastric cancer. The purpose of this review is to summarize the concepts and origin of ABO and other blood groups systems and Chemistry of Blood group specificity (Glycoproteins found in body fluids).

HEMOLYTIC DISEASE OF THE NEWBORN DUE TO ANTI-A AND ANTI-B

PEDIATRICS ◽  
1955 ◽  
Vol 15 (1) ◽  
pp. 54-62
Author(s):  
Clare N. Shumway ◽  
Gerald Miller ◽  
Lawrence E. Young
Keyword(s):  
B Cells ◽  
Red Blood Cells ◽  
Blood Group ◽  
Newborn Infant ◽  
Blood Cells ◽  
Osmotic Fragility ◽  
Red Cells ◽  
Hemolytic Disease ◽  
Abo Incompatibility

Ten infants with hemolytic disease of the newborn due to ABO incompatibility were studied. In every case the investigations were undertaken because of jaundice occurring in the first 24 hours of life. The clinical, hematologic and serologic observations in the infants and the serologic findings in the maternal sera are described. Evidence is presented to show that the diagnosis of the disorder rests largely upon the demonstration of spherocytosis, increased osmotic fragility of the red cells, reticulocytosis, and hyperbilirubinemia in a newborn infant whose red blood cells are incompatible with the maternal major blood group isoantibody and against whose cells no other maternal isoantibody is demonstrable. The anti-A or anti-B in each of the maternal sera tested in this series hemolyzed A or B cells in the presence of complement. Other serologic findings in the maternal sera were less consistently demonstrated.

scholarly journals Hemolytic Disease of the Newborn Due to Anti-A

Blood ◽  
1953 ◽  
Vol 8 (7) ◽  
pp. 620-639 ◽  
Author(s):  
HAL CRAWFORD ◽  
MARIE CUTBUSH ◽  
P. L. MOLLISON
Keyword(s):  
Blood Group ◽  
Osmotic Fragility ◽  
Red Cells ◽  
Coombs Test ◽  
Hemolytic Disease ◽  
A Cells

Abstract Eleven cases of hemolytic disease of the newborn are described in which the only blood group antibody in the mother's serum, incompatible with the infant's cells, was anti-A. The direct antiglobulin (Coombs) test on the infant's red cells was weakly positive in 7 cases and negative in 4 cases. In every case the mother's serum displayed immune characteristics, in particular the ability to lyse A cells. Osmotic fragility was increased in 10 out of 11 cases. This finding is contrasted with those in a series of cases of hemolytic disease of the newborn due to anti-Rh.

STUDIES ON ERYTHROBLASTOSIS DUE TO ABO INCOMPATIBILITY

PEDIATRICS ◽  
1954 ◽  
Vol 13 (6) ◽  
pp. 503-510
Author(s):  
DAVID YI-YUNG HSIA ◽  
SYDNEY S. GELLIS
Keyword(s):  
Blood Group ◽  
Bilirubin Level ◽  
Serum Bilirubin ◽  
Laboratory Data ◽  
Serum Bilirubin Level ◽  
Present Knowledge ◽  
Coombs Test ◽  
Abo Incompatibility ◽  
Rh Incompatibility

Detailed clinical and laboratory data have been presented on 21 infants with erythroblastosis due to ABO incompatibility. A careful survey in one newborn service over a six-month period showed that there were 11 cases of erythroblastosis due to ABO incompatibility as compared to 7 cases of erythroblastosis due to Rh incompatibility, suggesting that the disease occurs with greater frequency than has been hitherto reported. No one test is available which can in every case be absolutely diagnostic of the disease. The criteria useful in suggesting the diagnosis are listed. Practically, the presence of a major blood group incompatibility between infant and mother with a negative Coombs' test, clinical jaundice in the first 24 hours, and a serum bilirubin level of more than 10 mg./100 cc. at 24 hours or less is sufficient to make the diagnosis in the absence of manifest infection. The same criteria for treatment as applied to Rh erythroblastosis should be applied to erythroblastosis due to ABO incompatibility in the light of our present knowledge.

scholarly journals History of the Rhesus factor and of neonatal jaundice

2021 ◽  
Vol 16 (S4) ◽  
pp. 7-10
Author(s):  
Vlad DIMA ◽  
◽  
Andreea CALOMFIRESCU-AVRAMESCU ◽  
Ana Maria Alexandra STĂNESCU ◽  
Anca A. SIMIONESCU ◽  
...  
Keyword(s):  
Blood Group ◽  
Neonatal Jaundice ◽  
Metabolic Diseases ◽  
Fetal Anemia ◽  
Hemolytic Disease ◽  
Non Invasive ◽  
Rhesus Factor ◽  
Antigen Transfer ◽  
History Of ◽  
Rh Blood Group

The history of icterus and neonatal jaundice has been recorded since the 17th century, when a French midwife first described jaundice (jaune) in twins. In 1940, Alexander Wiener and Karl Landsteiner discovered the Rh blood group, and they investigated the isoimmunization via antigen transfer across the placenta from the fetus. Other blood group systems implicated in isoimmunization were discovered between 1901 and 1965. Between 1940-1960, many studies have focused on the etiology of hemolytic disease of the newborn, on incompatibility in the Rh system, cholestasis, metabolic diseases, inhibitors of breast milk, and the association between prematurity and jaun-dice or extremely nuclear jaundice. It is the merit of AW Liley, in 1963, who described the diagram of the same name based on the level of bilirubin in the amniotic fluid and who performed the first fetal transfusions for fetal anemia. Last decades, non-invasive methods of diagnosis and treatment were described.

scholarly journals HEMOLYTIC DISEASE OF THE NEWBORN

2018 ◽  
Vol 18 (2) ◽  
pp. 104-109
Author(s):  
Vivi Keumala Mutiawati
Keyword(s):  
Blood Group ◽  
Blood Groups ◽  
Maternal Antibodies ◽  
Placental Barrier ◽  
Abo Blood Groups ◽  
Hemolytic Disease ◽  
Gene Frequencies ◽  
Mild Degree ◽  
Abo Incompatibility ◽  
Low Incidence

Abstrak. Pemahaman penyakit hemolitik pada bayi baru lahir telah berubah selama beberapa dekade terakhir. Penyakit hemolitik akibat inkompatibilitas ABO dan aloantibodi lainnya kini muncul sebagai penyebab utama. Banyak negara telah mengidentifikasi aloantibodi selain anti D sebagai penyebab penyakit hemolitik dengan gejala klinis sedang sampai dengan berat. Prevalensi dan frekuensi populasi antibodi anti-A dan anti B dari golongan darah ABO berguna dalam memprediksi perkiraan anak yang lahir oleh wanita golongan darah O yang menikahi suami golongan darah bukan O yang berisiko menjadi ABO HDN. Kelainan ABO HDN disebabkan oleh antibodi IgG pada ibu disebabkan kemampuan IgG untuk melewati sawar darah plasenta. Eritrosit yang peka oleh antibodi dihancurkan oleh makrofag pada limpa janin dengan gejala klinis hiperbilirubinemia. Kelainan ABO HDN memberikan gambaran klinis yang lebih ringan pada populasi, dan ditandai dengan derajat hemolisis yang ringan. Diagnosis biasanya dilakukan dengan pemeriksaan bayi baru lahir yang telah mengalami ikterus pada hari pertama kehidupan. Keywords: Penyakit hemolitik bayi baru lahir, aloantibodi golongan darah, ikterus Abstract. The spectrum of hemolytic disease of the newborn has changed over the last decades. Hemolytic disease due to ABO incompatibility and other alloantibodies has now emerged as major causes. Many countries have identified alloantibodies other than anti D as a cause of moderate-severe hemolytic disease. The prevalence of immune anti A and anti B antibodies and the population and gene frequencies of the various ABO blood groups are useful in predicting an estimate of children born by blood group O women married to non-group O husband who are at risk of developing ABO HDN. ABO HDN is caused by IgG maternal antibodies which have the ability to cross the placental barrier. The red cells which are sensitized by the antibodies are destroyed by macrophages in fetal spleen with consequent hyperbilirubinemai. ABO HDN is described as a condition having a very low incidence in the population and characterized by a a mild degree of hemolysis. Diagnosis is usually made by investigation of a newborn baby who has developed jaundice during the first day of life. Keywords: Hemolytic disease of the newborn, blood groups alloantibodies, joundice 

Complement in ABO—Hemolytic Disease of the Newborn

PEDIATRICS ◽  
1971 ◽  
Vol 48 (4) ◽  
pp. 650-653
Author(s):  
May Y. F. W. Wang ◽  
Jane F. Desforges
Keyword(s):  
Newborn Infants ◽  
Red Cells ◽  
Coombs Test ◽  
Hemolytic Disease ◽  
Direct Coombs Test ◽  
Group I ◽  
Group A ◽  
Group Ii ◽  
Abo Hemolytic Disease ◽  
Positive Direct

Complement titres were measured in three groups of newborn infants from group O mothers: I. 31 group O infants. II. 10 group A or B infants with probable ABO hemolytic disease of the newborn (ABO HDN). III. 18 group A or B infants without ABO HDN. Seven of the Group II infants had positive direct Coombs' test, and one of these required exchange transfusion; the three babies with negative direct Coombs' test had clinical course compatible with ABO HDN. There was no significant difference in the complement titres among these various groups. Anti-serum to human C3 and C4 was used to detect complement components on the fetal red cells of 4 infants in Group I, 5 infants in Group II, and eight infants in Group III. The reaction was negative in all these cases. These results suggest that complement does not participate in the in vivo destruction of red cells in cases of hemolytic disease of newborn infants due to ABO incompatibility.

scholarly journals Cord Serum Bilirubin Level in Predicting the Development of Significant Hyperbilirubinemia in Newborns with ABO Incompatibility

2016 ◽  
Vol 35 (3) ◽  
pp. 231-236
Author(s):  
Sunita Arora ◽  
Shifali
Keyword(s):  
Blood Group ◽  
Bilirubin Level ◽  
Serum Bilirubin ◽  
Tertiary Care ◽  
Serum Bilirubin Level ◽  
Total Serum ◽  
Care Hospital ◽  
Hemolytic Disease ◽  
Cord Serum ◽  
Abo Incompatibility

Introduction: Neonatal hyperbilirubinaemia is common problem which is benign in majority of neonates. Rh iso immune hemolytic disease as a cause of hyperbilirubinemia is becoming nearly nonexistent due to the use of prophylactic anti D. Hence Isoimmune hemolytic disease due to ABO incompatibility assumes significance as a cause of significant hyperbilirubinaemia. This study was conducted to determine the incidence of ABO incompatibility, ABO iso immune disease in new born, to determine critical cord serum bilirubin level to predict subsequent significant hyperbilirubinemia.Material and Methods: The study was done in neonatal ICU of a tertiary care hospital where 100 full term healthy newborns with B.W≥2500gm and gestational age ≥37 wk with blood group A, B, AB, born to mothers with O blood group without simultaneous Rh incompatibility at SGRDIMSR were included. Serum bilirubin was measured approximately at 12-24hrs, 36-48hrs, 60-72hrs. Results: Out 100 ABO incompatible newborns 33(33%) developed ABO isoimmune disease manifesting as significant hyperbilirubinaemia with any of the four total serum bilirubin levels exceeding threshold levels defined for phototherapy. TSB of ≥ 2.16mg/d1 from cord blood has a sensitivity of 100% specificity of 89.55%, NPV 100% and PPV of 82.50% to predict significant hyperbilirubinaemia. Conclusion: A critical cord S.bilirubin between 2.16 mg/d1 and 4.09mg/d1 will predict all newborns who will have significant hyperbilirubinaemia and can be used as a safe demarcator to decide time of discharge. Any therapeutic intervention if necessary can be started as early as possible.J Nepal Paediatr Soc 2015; 35(3): 231-236 

scholarly journals Serological profile and hemolytic disease in term neonates with ABO incompatibility

2009 ◽  
Vol 49 (4) ◽  
pp. 219 ◽  
Author(s):  
Desiana Dharmayani ◽  
Djajadiman Gatot ◽  
Rinawati Rohsiswatmo ◽  
Bambang Tridjaja
Keyword(s):  
Blood Type ◽  
Hemolytic Disease ◽  
Chi Square ◽  
Cross Sectional ◽  
Term Neonates ◽  
Serological Profile ◽  
Abo Incompatibility ◽  
Elution Method ◽  
Positive Direct ◽  
Chi Square Analysis

Background Hemolytic disease of the newborn (HDN) due toABO blood type incompatibility is one of the most commoncause of neonatal hyperbilirubunemia that potentially leads tobilirubin encephalopathy. Data on ABO-hemolytic disease of thenewborn (ABO-HDN), especially regarding umbilical cord bloodserological profile, are limited.Objective To identify the serological profile and hemolytic disease in term neonates with ABO incompatibility.Methods This was a cross-sectional descriptive study, conductedat RSIA Budi Kemuliaan Jakarta.Results We found 68 healthy term neonates with ABOincompatibility, nine of them had positive direct antiglobulintest (OAT) result, and 38 subjects had a positive result onOAT with elution method. The highest titer of IgG was 1:8.Hyperbilirubinemia was found in 30 ( 44%) subjects, andABO-HDN was diagnosed in 28 (41 %) subjects. Within thepositive OAT group, eight out of nine subjects had sufferedfrom hyperbilirubinemia and ABO-HDN. Meanwhile, withinthe positive OAT with elution method group; 24 subjects hadsuffered from hyperbilirubinemia with 23 of them having ABOHDN. Based on the chi-square analysis; those with positive OAT with elution method had 3.2 times higher risk of suffering from ABO-HDN. Furthermore, there was a 3.6 times higher risk ofsufferring from hyperbilirubinemia.Conclusion In healthy term neonates with ABO incompatibility,the incidence of ABO-HDN is 41%. OAT serological examinationwith elution method is better than OAT in assessing riskfor hyperbilirubinemia and ABO-HDN.

scholarly journals Naturally Occurring ‘enzyme only’ Anti-E antibody: A Rare Occurrence

2019 ◽  
Vol 18 (4) ◽  
pp. 818-819
Author(s):  
Rabeya Yousuf ◽  
Nor Fadzliana Abdullah Thalith ◽  
Tang Yee Loong ◽  
Chooi Fun Leong
Keyword(s):  
Case Report ◽  
Blood Group ◽  
Rare Case ◽  
Medical Science ◽  
Blood Group System ◽  
Red Cell ◽  
Rare Occurrence ◽  
Naturally Occurring ◽  
Cell Antibody ◽  
Rh Blood Group

Naturally occurring anti-E, present without obvious antigenic stimulation is a rare occurrence of red cell antibody of the Rh blood group system. It is mentioned that such naturally occurring anti-E react only with enzyme modified E-positive red cells. This case report describes a rare case of naturally occurring anti-E in a patient with autoimmune haemolytic anaemia (AIHA). Bangladesh Journal of Medical Science Vol.18(4) 2019 p.818-819

Sign in / Sign up

Export Citation Format

Share Document