Routray Suman S, Sahoo Jagdish P, Behera Rachita, Acharya Devi, Kanungo Girija N
Transfusion Medicine, All India Institute of Medical Sciences, Bhubaneshwar, Bhubaneswar, IND.
Neonatology, Institute of Medical Sciences (IMS) and SUM Hospital, Bhubaneswar, IND.
Cureus. 2020 Dec 17;12(12):e12121. doi: 10.7759/cureus.12121.
Anti-D is the most common cause of hemolytic disease of the newborn (HDN) in the developing countries even after the introduction of anti-D immunoprophylaxis. Still, ABO incompatibility and other alloantibodies against minor blood group antigens have emerged as significant causes of HDN. Moreover, ABO incompatibility acts as a protective barrier to the expression of Rh isoimmunization. Here we are presenting a case of HDN where both Rh and ABO incompatibility co-existed with their manifestations in a B positive neonate born to an O positive mother. Use of appropriate elution technique can aid in the diagnosis of such cases. Hence, antenatal screening of all mothers irrespective of their Rh D status can help in early diagnosis and proper management that can decrease the neonatal morbidity and mortality.
即使在引入抗-D免疫预防措施后，抗-D仍是发展中国家新生儿溶血病（HDN）的最常见病因。尽管如此，ABO血型不相容以及针对次要血型抗原的其他同种抗体已成为HDN的重要病因。此外，ABO血型不相容对Rh血型同种免疫的表达起到了保护屏障的作用。在此，我们报告一例HDN病例，其中Rh和ABO血型不相容在一名O型阳性母亲所生的B型阳性新生儿中同时存在并表现出来。使用适当的洗脱技术有助于此类病例的诊断。因此，对所有母亲进行产前筛查，无论其Rh D状态如何，都有助于早期诊断和妥善管理，从而降低新生儿发病率和死亡率。
