Abourazzak Sana, Hajjaj Safae, Hakima Chekabab, Bouharrou Abdelhak, Hida Moustapha
University Hospital Hassan II, Department of Neonatology, Service de Pédiatrie, CHU Hassan II, Fez, 30 000, Morocco.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.09.2008.0987. Epub 2009 Feb 26.
Anti-D isoimmunisation remains the most common cause of erythroblastosis fetalis. Whereas most clinically significant blood group sensitisations noted during pregnancy are still secondary to anti-D incompatibility, sensitisation to antigens other than D in the CDE system is not uncommon and can cause severe disease. The widespread use of Rh-D immune globulin has led to a relative increase in the importance of non-Rh-D isoimmunisation as a cause of haemolytic disease of the newborn. We report the case of a baby with severe hyperbilirubinaemia and persistent anaemia due to anti-c isoimmunisation with a high-titre maternal c antibody. The baby required emergency transfusion and intensive phototherapy. The medical literature relating to maternal c isoimmunisation and neonatal outcome is also reviewed. Because of its ability to cause clinically significant haemolytic disease of the newborn, practitioners must manage anti-c isoimmunisation in a manner similar to that for anti-D.
抗-D同种免疫仍然是胎儿成红细胞增多症最常见的病因。尽管孕期发现的大多数具有临床意义的血型致敏仍是抗-D不相容所致,但对CDE系统中D以外抗原的致敏并不罕见,且可导致严重疾病。Rh-D免疫球蛋白的广泛使用使得非Rh-D同种免疫作为新生儿溶血病病因的重要性相对增加。我们报告了一例因母亲高滴度c抗体引起的抗-c同种免疫导致严重高胆红素血症和持续性贫血的婴儿病例。该婴儿需要紧急输血和强化光疗。同时还对与母亲c同种免疫和新生儿结局相关的医学文献进行了综述。由于其能够引起具有临床意义的新生儿溶血病,从业者必须以类似于处理抗-D的方式来处理抗-c同种免疫。