Anti-D antibodies in D- and Du-positive women: a cause of hemolytic disease of the newborn.

Regardless of the decrease in Rh sensitization as a cause of hemolytic disease of the newborn, antenatal antibody screening must be performed in all patients to detect not only anti-D sensitization, but other less common antibodies capable of provoking hemolytic disease of the newborn. The relative incidence of hemolytic disease of the newborn due to sensitization to such irregular antibodies as Kell, Kidd, and Duffy is increasing. We report here five patients who had D- or Du-positive blood with antenatal anti-D sensitization, and whose neonates had hemolytic disease of the newborn of varying severity. Blood that is D- and Du-positive with anti-D has been classified by Tippett; such blood types lack part of the D mosaic and are considered to be "D variants" yet are typed routinely as Rh positive. Anti-D antibody produced by D- and Du-positive blood is indistinguishable from the ordinary variety of anti-D.