Rauch Stefan, Ritgen Jochen, Wißkirchen Matthias, Bauerfeind Ursula, Kohne Elisabeth, Weinstock Christof
Labor Prof. G. Enders & Kollegen MVZ GbR, Stuttgart, Germany.
Praenatal.de Köln, Prenatal Medicine and Genetics.
Transfusion. 2017 Jun;57(6):1485-1487. doi: 10.1111/trf.14078. Epub 2017 Mar 7.
Rd (SC4) is a low-frequency antigen of the Scianna blood group system. Only very few reports on anti-Rd in pregnancy exist. Mild to moderate hemolytic disease of the newborn caused by anti-Rd has been reported. This report may add further information on the clinical significance of anti-Rd for the fetus.
In a case of severe fetal anemia (hemoglobin concentration, 3.0 g/dL) repeated intrauterine transfusions were required. The strongly positive direct antiglobulin test (DAT) of the fetal red blood cells led to the diagnosis of hemolytic disease. The routine antibody screen was negative, extended testing revealed a maternal anti-Rd with a titer of 256. Both the newborn and her father were confirmed to carry the SC*01.04 allele.
Anti-Rd can cause fetal anemia. Low-frequency antigens including Rd are normally not present on screening cells. Antibodies directed against low-frequency antigens will usually not be detected by routine antibody screening in pregnancy. Thus, in cases of fetal anemia the DAT should always be included in the diagnostic workup.
Rd（SC4）是斯恰纳血型系统的一种低频抗原。关于孕期抗-Rd的报道极少。已有报道称抗-Rd可导致新生儿轻度至中度溶血病。本报告可能会进一步补充抗-Rd对胎儿临床意义的相关信息。
在一例严重胎儿贫血（血红蛋白浓度为3.0g/dL）的病例中，需要反复进行宫内输血。胎儿红细胞的直接抗球蛋白试验（DAT）呈强阳性，从而诊断为溶血病。常规抗体筛查为阴性，进一步检测发现母亲有抗-Rd，效价为256。新生儿及其父亲均被证实携带SC*01.04等位基因。
抗-Rd可导致胎儿贫血。包括Rd在内的低频抗原通常不存在于筛查细胞上。孕期常规抗体筛查通常检测不出针对低频抗原的抗体。因此，在胎儿贫血的病例中，诊断检查应始终包括DAT。
