ABSTRACT
The Miltenberger (Mi) classes represent a group of phenotypes for red cells that carry low frequency antigens associated with the MNSs blood group system. This pilot study was aimed at determining the Mia antigen positivity in the blood donor population in a tertiary care hospital in New Delhi, India. The study was performed between June to August 2014 on eligible blood donors willing to participate. Antigen typing was performed using monoclonal anti-Mia antiserum by tube technique. Only one of the 1000 blood donors (0.1%) tested was found to be Mia antigen positive. The Mia antigen can, therefore, be considered as being rare in the Indian blood donor population.
ABSTRACT
Authors experienced a newborn treated with severe anemia transferred to our hospital due to pulselessness and apnea shortly after birth. Laboratory analysis of the blood on admission revealed hemoglobin 3.1 g/dL, reticulocyte 11.0%. Kleihauer-Betke test for fetal hemoglobin from maternal blood was seen Hgb F 7%, then we suggested almost 180 ml fetomaternal hemorrhage. But, anemia was not improved despite repeated packed RBC transfusion. So, we evaluated the other cause of intractable anemia. The results were as follows; the Coombs' test was positive. The antibody identification test using mother's serum revealed anti-Mia antibody. The patient improved with supportive treatment, but got hypoxic brain injury due to massive fetomaternal hemorrhage. At day 29, the infant was doing well and was discharged. We report a case of neonatal isoimmune hemolytic disease due to anti-Mia with massive fetomaternal hemorrhage with a brief review of the related literatures.
Subject(s)
Female , Humans , Infant , Infant, Newborn , Pregnancy , Anemia , Apnea , Brain Injuries , Coombs Test , Fetal Hemoglobin , Fetomaternal Transfusion , Parturition , ReticulocytesABSTRACT
We report a case of hemolytic disease of the newborn caused by anti-Mia (Miltenberger) antibody. Full term male infant was admitted due to hyperbilirubinemia on second day of life. Total serum bilirubin level was 8.6 mg/dL at 12 hours of age and 12.3 mg/dL at 24 hours of age. The blood group of patient and his mother were both RhD positive B type. Direct antiglobulin test was strongly positive in the patient, and testing of maternal serum and patient's serum against a red cell panel including cells known to carry the antigenic determinants of some Miltenberger phenotypes revealed the presence of anti-Mia . Testing of paternal red cells and patient's red cell against anti-Mia serum revealed positive reaction. This report documents the first case of hemolytic disease of the newborn due to anti-Mi a in Korea.
Subject(s)
Humans , Infant , Infant, Newborn , Male , Bilirubin , Coombs Test , Epitopes , Hyperbilirubinemia , Korea , Mothers , PhenotypeABSTRACT
We report a case of naturally-occurring anti-Miltenberger (anti-Mia(a)) antibody in a 16-year-old man who had never been transfused before. During an operation for a trauma he received 2 units of packed red blood cells. He was negative on an antibody screening test, but positive a week after the surgery when an extended screening test was conducted using blood cells positive for Miltenberger III (Mi.III) phenotype. The Mi.III phenotype is a low incidence antigen among Caucasians, however, it is reported to be relatively high in incidence among people in South-East Asia. Anti-Mia(a) antibodies are clinically significant antibodies that cause hemolytic transfusion reactions (HTRs) and hemolytic disease of the newborns (HDNs). In addition, anti-Mia(a) has a high rate of incidence among Thais, Taiwanese, and Hong Kong Chinese. There has been no particular report on Koreans regarding the incidence of this antibody, it would therefore require further research on the Mi.III phenotype and anti-Mia(a).