RESUMEN
The Kidd system of blood group is clinically significant since the anti-Kidd antibody can cause immediate or delayed hemolytic transfusion reactions as well as hemolytic disease of newborn (HDN). In contrast to the hemolytic activity of Kidd antibodies in incompatible transfusion, the severity of HDN varies but usually tends to be a benign clinical course with favorable outcomes. And severe HDN due to anti-JKa incompatibility is a rare, which is still not reported in Korea. We experienced a newborn with severe jaundice to be detected within 24 hours from birth due to anti-JKa incompatibility. The laboratory data on admission indicated hemoglobin 13.2 g/dL, reticulocyte 4.08%, total bilirubin 18.7 mg/dL, and direct and indirect antiglobulin tests were positive (2+/2+). But, there are no ABO and Rh (D) incompatibilities between the mother and newborn. Maternal serum was found to contain an antibody that recognized JKa , and also seen in neonate. This patient completely recovered with intensive phototherapy without exchange transfusion. We report this case with a brief review of relevant literature.
Asunto(s)
Humanos , Recién Nacido , Anticuerpos , Bilirrubina , Incompatibilidad de Grupos Sanguíneos , Prueba de Coombs , Eritroblastosis Fetal , Hemoglobinas , Ictericia , Corea (Geográfico) , Madres , Parto , Fototerapia , ReticulocitosRESUMEN
The Kidd system of blood group is clinically significant since the anti-Kidd antibody can cause immediate or delayed hemolytic transfusion reactions as well as hemolytic disease of newborn (HDN). In contrast to the hemolytic activity of Kidd antibodies in incompatible transfusion, the severity of HDN varies but usually tends to be a benign clinical course with favorable outcomes. And severe HDN due to anti-JKa incompatibility is a rare, which is still not reported in Korea. We experienced a newborn with severe jaundice to be detected within 24 hours from birth due to anti-JKa incompatibility. The laboratory data on admission indicated hemoglobin 13.2 g/dL, reticulocyte 4.08%, total bilirubin 18.7 mg/dL, and direct and indirect antiglobulin tests were positive (2+/2+). But, there are no ABO and Rh (D) incompatibilities between the mother and newborn. Maternal serum was found to contain an antibody that recognized JKa , and also seen in neonate. This patient completely recovered with intensive phototherapy without exchange transfusion. We report this case with a brief review of relevant literature.
Asunto(s)
Humanos , Recién Nacido , Anticuerpos , Bilirrubina , Incompatibilidad de Grupos Sanguíneos , Prueba de Coombs , Eritroblastosis Fetal , Hemoglobinas , Ictericia , Corea (Geográfico) , Madres , Parto , Fototerapia , ReticulocitosRESUMEN
We report on two cases of anti-Jka, whose reactivity disappeared on an antibody identification test using enzyme-treated red cells. One of two patients was a 72-year-old female with cirrhosis of the liver and colon cancer, and the other was a 55-year-old female with known MDS and incomplete Behcet's disease. Results of an antibody identification test using a LISS/Coombs gel card (DiaMed AG) showed negative to one positive with red cells having the Jka antigen; however, all reactions using the enzyme-treated cells showed negative results, which was unexpected. The patients' RBC phenotype was Jk(a-b+). We obtained positive results in reactions of enzyme-treated Jka+ cells and EDTA using a patient's serum and proved that the cause of the negative reaction might be complement-related.
Asunto(s)
Anciano , Femenino , Humanos , Persona de Mediana Edad , Neoplasias del Colon , Ácido Edético , Fibrosis , Hígado , FenotipoRESUMEN
It is very important to prevent hemolytic transfusion reaction. We experienced 1 case of transfusion in liver transplantation patient with multiple unexpected antibodies. On crossmatching for 20 pRBC (packed red blood cells), weak reactions were observed in room temperature, but strong reactions were observed in 37 , and AHG (antihuman globulin) phase. The patient had unexpected antibodies of anti-C, anti-Jka, anti-Dia. The probabilitis of compatible blood of anti-C, anti-Jka, anti-Dia in Koreans had been reported to be 14.2%, 32.8%, and 90%, respectively. We received 217 units of C antigen-negative pRBCs prepared by typing of 2679 type B pRBCs from Central, Eastern and Southern Blood Center of the Korean Red Cross. From the 217 units, 60 units of pRBCs compatible with patient's serum in AHG phase were prepared in our laboratory. The hemolytic tranfusion reaction can be successfully prevented by aid of Blood Center of Korean Red Cross and it should be emphasized that performing crossmatching including AHG phase is very important.
Asunto(s)
Humanos , Anticuerpos , Incompatibilidad de Grupos Sanguíneos , Trasplante de Hígado , Hígado , Cruz Roja , TrasplanteRESUMEN
We report a case of delayed hemolytic transfusion reaction due to anti-Jka antibody. The patient was a 68-year-old women who was admitted for general weakness after subtotal thyroidectomy. She received two units of packed red cells because of anemia. On the fifteenth post-transfusion day, she developed a marked fall in hemoglobin and mild hyperbilirubinemia. Direct antiglobulin test was positive. Anti-Jka antibody was identified in her serum, and her phenotype of Kidd blood group was Jk(a-b+). Therefore the anti-Jka antibody was thought to be the possible offending antibody in this delayed hemolytic transfusion reaction.