Furukawa K, Nakajima T, Kogure T, Yazaki K, Yoshida M, Fukaishi T, Ibuki Y, Igarashi M
Department of Legal Medicine, Gunma University School of Medicine, Maebashi, Japan.
Exp Clin Immunogenet. 1993;10(3):161-7.
Serological and hematological investigations are reported for a woman who had multiple intrauterine deaths due to anti-M. The mother was group O Ns and the husband's cells were shown to be group O MSs. In the serological examination during the third pregnancy anti-M antibodies were identified in her serum. The antibodies comprised IgM saline agglutinin at a titer of 256 at 4 degrees C and IgG agglutinin reacted in an indirect antiglobulin technique at a titer of 4,096 at 37 degrees C. After the intrauterine death at 14 weeks gestation of her fifth pregnancy she underwent plasmapheresis 6 times on a biweekly program. Approximately 2 liters of plasma were exchanged for 1 liter of plasma protein fraction and 1 liter of fresh frozen plasma. In her sixth pregnancy, intensive plasmapheresis was started from 2 months gestation and a total of 56 liters plasma were exchanged. The anti-M titer fell to 256. She delivered a live girl by induction of labor at 35 weeks. The child was group O MNs. Her red cells had a positive direct antiglobulin reaction and her serum contained IgG anti-M antibody. Phototherapy was carried out and the child developed normally.
本文报告了一名因抗-M导致多次宫内死亡的女性的血清学和血液学检查结果。母亲为O Ns血型，丈夫的细胞显示为O MSs血型。在第三次怀孕的血清学检查中，在她的血清中发现了抗-M抗体。这些抗体包括4℃时滴度为256的IgM盐水凝集素，以及37℃时在间接抗球蛋白技术中反应、滴度为4096的IgG凝集素。在她第五次怀孕14周时发生宫内死亡后，她按照每两周一次的方案进行了6次血浆置换。大约2升血浆被换成1升血浆蛋白组分和1升新鲜冰冻血浆。在她第六次怀孕时，从妊娠2个月开始进行强化血浆置换，共置换了56升血浆。抗-M滴度降至256。她在35周时引产分娩出一个活女婴。孩子为O MNs血型。她的红细胞直接抗球蛋白反应呈阳性，血清中含有IgG抗-M抗体。进行了光疗，孩子发育正常。
