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新生儿Jk溶血性疾病合并同种免疫性血小板减少症伴极重度贫血:一例报告并文献复习

Neonatal Jk hemolytic disease combined with alloimmune thrombocytopenia with extreme anemia: a case report with literature review.

作者信息

Luo Fangmei, Chen Shangliang, Li Wenfang, Zhou Ping

机构信息

Department of Neonatology, Guangdong Women and Children Hospital, Guangzhou, China.

Department of Laboratory, Baoan Women's and Children's Hospital, Shenzhen, China.

出版信息

BMC Pediatr. 2025 May 19;25(1):398. doi: 10.1186/s12887-025-05749-8.

Abstract

BACKGROUND

Only isolated occurrences of neonatal Jk hemolytic disease have been identified, and no cases of Jk hemolytic disease combining fetal and neonatal alloimmune thrombocytopenia (FNAIT) have been reported. The majority of medical professionals lack sufficient knowledge regarding Jk hemolytic disease, which could result in missed diagnoses and early misdiagnoses.

CASE PRESENTATION

In this study, a case of a male newborn with extreme anemia and thrombocytopenia is reported. The newborn and his mother were identified as blood groups O RhD + and Jk(a + b+), and O RhD + and Jk(a-b+). Anti-Jk was identified in the plasma of both the mother and newborn. Thrombocytopenia and upper gastrointestinal bleeding were observed in the newborn, and both mother and newborn tested positive for platelet antibodies. The extreme anemia and thrombocytopenia were successfully treated with red cell transfusions and immunoglobulin.

CONCLUSION

Co-existence of neonatal Jk hemolytic disease and FNAIT is very rare in newborns with significant clinical manifestations. Early diagnosis and timely treatment are crucial for improving patient outcomes.

摘要

背景

仅发现过孤立的新生儿Jk溶血病病例,尚未有合并胎儿及新生儿同种免疫性血小板减少症(FNAIT)的Jk溶血病病例报道。大多数医学专业人员对Jk溶血病缺乏足够的了解,这可能导致漏诊和早期误诊。

病例报告

本研究报告了1例患有严重贫血和血小板减少症的男性新生儿病例。新生儿及其母亲的血型分别为O RhD+ Jk(a+b+)和O RhD+ Jk(a-b+)。在母亲和新生儿的血浆中均检测到抗Jk。新生儿出现血小板减少症和上消化道出血,母亲和新生儿的血小板抗体检测均呈阳性。通过红细胞输注和免疫球蛋白成功治疗了严重贫血和血小板减少症。

结论

新生儿Jk溶血病与FNAIT并存的情况在有明显临床表现的新生儿中非常罕见。早期诊断和及时治疗对于改善患者预后至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/509d/12087219/69ed2b56f62a/12887_2025_5749_Fig1_HTML.jpg

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