A case of hemolytic disease of the newborn infant due to anti-K (Cellano).

Hemolytic disease of the newborn infant (HDN) due to anti-K (Cellano) is very uncommon in Caucasians. We report here a case of anti-K HDN. The anti-K alloimmunization appeared in the mother during her fifth pregnancy. This HDN needed an exchange transfusion immediately after delivery. The clinical outcome of the newborn infant was good.

Haemolytic disease of the newborn infant. Long term efficiency of the screening and the prevention of alloimmunization in the mother: thirty years of experience.

During the last thirty years, the diagnosis, management and prevention of haemolytic disease of the newborn infant (HDN) have improved. From 1959 to 1988, 3004 HDN (ABO excluded) have been collected. The percentage of HDN with anti-D alloimmunization decreased significantly (98.4% from 1959 to 1968, 93.5% from 1969 to 1978 and 68.1% from 1979 to 1988). The anti-D HDN with exchange transfusion (ET) fell significantly between the first and second periods (577 versus 970; chi 2 = 19.92; P less than 0.001). On the other hand, the number of HDN other than anti-D increased during these three periods, but the percentage of these HDN which needed ET decreased. Our study shows the long term efficiency of the prevention of anti-D alloimmunization (since 1970) and of the irregular antibodies screening among all pregnant women (since 1979).

Haemolytic disease of two newborns in a Rhesus anti-e alloimmunized woman. Review of literature.

Haemolytic disease of the newborn (HDN) due to Rhesus anti-e alone is rarely observed in the Caucasian population. We report here a case of an R2R2 mother who had never been transfused and whose two children had a mild HDN without transfusion or blood exchange transfusion (BE) after delivery.

Important variations of maternal anti-Rhesus (D) antibody level during two consecutive pregnancies without antigenic stimulus.

In many cases, during pregnancies of anti-D alloimmunized women, without antigenic stimulus, the anti-D concentration remains stable. We report here a case of a woman anti-D and anti-C alloimmunized which has presented high variation of anti-D concentration in her serum during two successive pregnancies with a Rh-negative fetus. Thus, the Liley Index only has confirmed the absence of fetal damage.

[Systematic detection of anti-erythrocyte alloimmunization during pregnancy. Experience at the Lyon Regional Blood Transfusion Center]. / Dépistage systématique de l'allo-immunisation anti-érythrocytaire au cours de la grossesse. L'expérience du Centre Régional de Transfusion Sanguine de Lyon.

In France, relative increases in hemolytic disease of the newborn (HDN) due to non anti-D maternal alloimmunization is linked to a systematic search and prevention of an anti-D alloimmunization in Rh negative women during and after pregnancy. In May 1985, detection of anti-red blood cell alloantibodies in all pregnant women has been ordered by a new law. We have observed the efficiency of this law by studying the number of HDN with anti-D and non anti-D maternal alloimmunization detected before and after delivery during the years 1984 and 1986. Our results show that this law is well used. Nevertheless, this work demonstrates that often clinicians omit to set cord blood aside for hemoglobin and bilirubinemia concentration determinations. Because these two parameters are very important in establishing the severity of HDN and therapeutic management, improvements are necessary.

[Hemolytic disease of newborn infants caused by anti-Diego antibodies]. / Maladie hémolytique du nouveau-né par anticorps anti-Diegoa (anti-Dia).

A native Cambodian woman delivered a third full-term female baby who had a strongly positive direct antiglobulin test. During the pregnancy and after the delivery, the woman had a negative irregular antibody screening test using standard red blood cell panels, but the indirect antiglobulin test between the mother's serum and the father's red blood cells was strongly positive. The antibody could be eluted from the baby's red blood cells and its was identified as an anti-Dia (Diegoa). The child developed a mild hyperbilirubinemia and recovered without treatment.

[A case of hemolytic disease in a newborn associated with anti-Wra (WRIGHT) antibodies]. / Un cas de maladie hémolytique du nouveau-né par anticorps anti-Wra (WRIGHT).

A french woman delivered a third full-term male baby who had a strongly positive direct antiglobulin test. During the pregnancy and after the delivery, the woman had a negative irregular antibody screening test using standard red blood cell panels. The compatibility testing between the mother's serum and the father's red blood cells was strongly positive and the antibody was identified as an anti-Wra. The baby developed a mild hyperbilirubinemia and recovered without treatment. This child was probably responsible for his mother's immunization since the two previous children were Wra negative and the mother had no history of blood transfusion or abortion.

[124 cases of hemolytic diseases in newborn infants other than ABO and Rhesus D observed in the Blood Transfusion Center of Lyon between 1970 and 1982]. / A propos de 124 cas de maladies hémolytiques du nouveau-ne autres que ABO et Rhesus D observées au centre de transfusion sanguine de Lyon entre 1970 et 1982.

Between 1970 and 1982, 124 cases of hemolytic diseases of the newborn due to antigens other than A, B and Rhesus-D were observed in the Blood Bank of Lyon (France). These cases represent 10,3% of all the hemolytic diseases of the newborn (ABO excluded). This percentage has raised during this period: 2,1% in 1970 until 39,2% in 1982. The variation is due both to the fall of the Rhesus-D hemolytic diseases and to the raise of non Rhesus-D hemolytic diseases. The alloantibody titer is not a good criteria in order to predict the anemia level of the newborn but the amniotic fluid delta OD 450 is satisfactory whatever the alloimmunisation is.

[Hemolytic disease of the newborn caused by maternal allo-immunization against erythrocyte antigens other than A, B and rhesus D]. / Maladies hémolytiques du nouveau-né par allo-immunisations maternelles contre les antigènes érythrocytaires autres que A, B et rhésus D.

The authors analyse numerous publications dealing with hemolytic disease of the newborn due to erythrocyte antigens other than A, B and Rhesus D. They emphasize the frequency of these diseases and the clinical presentation according to the antibody specificity. Finally, they suggest a practical management to treat these hemolytic diseases of the newborn.

[Immunohemolytic complications observed during transfusion of more than 2 million units of blood]. / Accidents immuno-hémolytiques observés au cours de la transfusion de plus de deux millions d'unités de sang.

From 1955 through 1978, 150 immunohemolytic accidents of variable gravity have been documented, representing an incidence of 7.1 cases out of 100 000 transfused blood units. These accidents can be classified as follows: 83 cases due to ABO incompatibility, 42 cases due to an irregular antibody in the recipient (six times due to anti-D), 20 cases induced by passive maternal antibodies in the newborn and 5 cases which were attributed to injected anti-A or anti-B antibodies. Ten deaths were recorded, all ascribed to ABO (8 cases) and to Rhesus D (2 cases) incompatibilities. In the present study, a major decrease in the incidence of ABO accidents has been observed, especially since 1966 with systematic controls being performed at the patient's bedside. However, irregular antibodies were the cause of the conflicts in only 10% of the cases when the study was started, and is now incriminated in 8 cases out of 10.

[Fetal death and benign hemolytic disease of the newborn from anti-Cellano alloimmunization: 2 new case reports]. / Mort foetale et maladie hémolytique bénigne du nouveau-né par allo-immunisation anti-Cellano: Deux nouvelles observations.

The first case is provided by a french women (KK, husband k/k) who delivered a first healthy full term infant in 1970 and received one blood unit at this time. In 1972 and 1975, his second and fourth pregnancies ended by spontaneous abortion. In 1974 and 1976, she delivered stillborn infants with hydrops fetalis during the sixth month. In serum, anti-k antibody reacted by the indirect antiglobulin test with a titer of 4 096. In the second case, french women delivered a first full term female infant who had a strongly positive direct antiglobulin test. The mother had received one blood unit ten years before during nephrectomy. Her red blood cell were KK and her husband was kk. She had a anti-Cellano in serum reactive in the indirect antiglobulin test with a titer of 16. The infant developed a mild hyperbilirubinemia and recovered without treatment these two cases confirm the variable effect of maternal anti-k antibody evidenced by few other published cases.