Schellong G, Sandmann G, Fischer K, Poschmann A
Dtsch Med Wochenschr. 1976 Oct 29;101(44):1591-7. doi: 10.1055/s-0028-1104308.
Rare forms of incompatibility were observed over a period of 20 years in 41 (2%) of 2088 new-borns with haemolytic disease. Antibodies involved were anti-c (n = 27), anti-E (n = 6) and anti-K (n = 4), as well as one case each of anti-E + Fya, -C, -Fya and -Jka. Amniotic fluid was examined during pregnancy in nine cases, three children were given intra-uterine infusions, while in the remainder the haemolytic process was mild or only moderately severe. One infant died of toxoplasmosis, another one of immaturity and respiratory distress syndrome. Kernicterus was always prevented. In haemolytic disease of the newborn caused by anti-c and anti-E, prenatal damage is markedly rarer than with D erythroblastosis, but must be considered during the pregnancy. In anti-K haemolytic disease the severity of the disease is similar to that of D erythroblastosis. All three incompatibilities may lead to kernicterus in the first few days after birth so that exchange transfusions are often necessary. In most of the other incompatibilities the course is similar to that seen with ABO erythroblastosis.
在2088例患有溶血病的新生儿中,41例(2%)在20年期间观察到罕见的血型不相容形式。涉及的抗体有抗 - c(n = 27)、抗 - E(n = 6)和抗 - K(n = 4),以及各1例抗 - E + Fya、抗 - C、抗 - Fya和抗 - Jka。9例在孕期检查了羊水,3例患儿接受了宫内输血,其余患儿的溶血过程较轻或仅为中度严重。1例婴儿死于弓形虫病,另1例死于早产和呼吸窘迫综合征。核黄疸均得以预防。在由抗 - c和抗 - E引起的新生儿溶血病中,产前损害明显比D型新生儿溶血病少见,但孕期必须予以考虑。在抗 - K溶血病中,疾病的严重程度与D型新生儿溶血病相似。所有这三种血型不相容都可能在出生后的头几天导致核黄疸,因此常常需要进行换血输血。在大多数其他血型不相容的情况下,病程与ABO血型新生儿溶血病所见相似。