Singh Bharat, Chaudhary Rajendra, Elhence Preeti, Bharati Jyoti Kala, Srivastava Anubha
Department of Transfusion Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Asian J Transfus Sci. 2022 Jan-Jun;16(1):121-123. doi: 10.4103/ajts.ajts_108_21. Epub 2022 May 26.
The widespread use of anti-D immunoglobulin has resulted in a relative increase in the importance of non-D alloimmunization as a cause of hemolytic disease of the fetus and newborn (HDFN). Non-D alloantibodies that are capable of causing severe HDFN include anti-K, anti-E, and anti-c. Anti-c is clinically the most important Rh system antibody after anti-D. Here, we report three cases of neonates presenting with anemia and hyperbilirubinemia with strongly positive direct antiglobulin test who required phototherapy and neonatal exchange transfusion due to non-D antibody in RhD positive antenatal women. Anti-c was common in all the three cases while two cases have one additional non-D antibody. Due to faulty practices, antenatal antibody screening was not done for any case considering the mother's RhD positive status. Hence, antenatal antibody screening should be performed routinely, in all RhD positive pregnant women to reduce the delay in diagnosis and the management of HDFN occurring due to non-D antibodies.
抗-D免疫球蛋白的广泛使用导致非-D同种免疫作为胎儿和新生儿溶血病（HDFN）病因的重要性相对增加。能够引起严重HDFN的非-D同种抗体包括抗-K、抗-E和抗-c。抗-c在临床上是仅次于抗-D的最重要的Rh系统抗体。在此，我们报告3例新生儿病例，这些新生儿表现为贫血和高胆红素血症，直接抗球蛋白试验呈强阳性，由于RhD阳性产前妇女体内存在非-D抗体，需要进行光疗和新生儿换血输血。抗-c在所有3例中均常见，而2例还有一种额外的非-D抗体。由于操作不当，考虑到母亲RhD阳性状态，所有病例均未进行产前抗体筛查。因此，应常规对所有RhD阳性孕妇进行产前抗体筛查，以减少因非-D抗体导致的HDFN诊断和管理延迟。
