Squires Amanda, Nasef Nehad, Lin Yulia, Callum Jeannie, Khadawardi Emad M, Drolet Christine, Core David, Simmons Brian
NICU at Sunnybrook Health Sciences Center, Toronto, Canada.
Neonatal Netw. 2012 Mar-Apr;31(2):69-80. doi: 10.1891/0730-0832.31.2.69.
Antibodies to red cell antigens that are found at low frequency in the general population are rare causes of hemolytic disease of the newborn. To understand how to detect these cases, we provide a basic review of routine antenatal maternal antibody testing and report a case of a neonate with severe HDN caused by anti-Wright (anti-Wra), successfully managed with transfusion, phototherapy, and high-dose intravenous immunoglobulin. When hemolysis in a newborn is suspected in the absence of major blood group incompatibility or commonly detected maternal red cell antibodies, a direct antiglobulin test should be performed. A positive DAT should alert the clinician to the presence of maternal antibodies against low-incidence antigens. Antibodies to the Wra antigen are one such rare cause of HDN.
针对在普通人群中低频出现的红细胞抗原的抗体，是新生儿溶血病的罕见病因。为了解如何检测这些病例，我们对常规产前母体抗体检测进行了基本回顾，并报告了一例由抗赖特（抗-Wra）引起的严重新生儿溶血病病例，该病例通过输血、光疗和大剂量静脉注射免疫球蛋白成功得到治疗。当怀疑新生儿发生溶血但不存在主要血型不相容或常见的母体红细胞抗体时，应进行直接抗球蛋白试验。直接抗球蛋白试验阳性应提醒临床医生存在针对低发生率抗原的母体抗体。抗Wra抗原的抗体就是导致新生儿溶血病的此类罕见病因之一。
