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Anti-D in a mother, hemizygous for the variant RHD*DNB gene, associated with hemolytic disease of the fetus and newborn.
- Source :
-
Transfusion [Transfusion] 2017 Aug; Vol. 57 (8), pp. 1938-1943. Date of Electronic Publication: 2017 Jun 21. - Publication Year :
- 2017
-
Abstract
- Background: Individuals with the partial D phenotype when exposed to D+ red blood cells (RBCs) carrying the epitopes they lack may develop anti-D specific for the missing epitopes. DNB is the most common partial D in Caucasians and the clinical significance for anti-D in these individuals is unknown.<br />Study Design and Methods: This article describes the serologic genotyping results and clinical manifestations in two group D+ babies of a mother presenting as group O, D+ with alloanti-D.<br />Results: The mother was hemizygous for RHD*DNB gene and sequencing confirmed a single-nucleotide change at c.1063G>A. One baby (group A, D+) displayed bilirubinemia at birth with a normal hemoglobin level. Anti-A and anti-D were eluted from the RBCs. For the next ongoing pregnancy, the anti-D titer increased from 32 to 256. On delivery the baby typed group O and anti-D was eluted from the RBCs. This baby at birth exhibited anemia, reticulocytosis, and hyperbilirubinemia requiring intensive phototherapy treatment from Day 0 to Day 9 after birth and was discharged on Day 13. Intravenous immunoglobulin was also administered. Both babies were heterozygous for RHD and RHD*DNB.<br />Conclusion: The anti-D produced by this woman with partial D DNB resulted in a case of hemolytic disease of the fetus and newborn (HDFN) requiring intensive treatment in the perinatal period. Anti-D formed by women with the partial D DNB phenotype has the potential to cause HDFN where the fetus is D+. Women carrying RHD*DNB should be offered appropriate prophylactic anti-D and be transfused with D- RBCs if not already alloimmunized.<br /> (© 2017 AABB.)
- Subjects :
- ABO Blood-Group System blood
DNA Mutational Analysis
Erythroblastosis, Fetal pathology
Erythroblastosis, Fetal therapy
Female
Fetal Diseases
Fetus
Genotype
Humans
Infant, Newborn
Mothers
Polymorphism, Single Nucleotide
Pregnancy
Rh-Hr Blood-Group System blood
Erythroblastosis, Fetal blood
Rh Isoimmunization complications
Rho(D) Immune Globulin adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1537-2995
- Volume :
- 57
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Transfusion
- Publication Type :
- Academic Journal
- Accession number :
- 28639307
- Full Text :
- https://doi.org/10.1111/trf.14156