Variable manifestations of minor blood group incompatibility

Authors

  • Pankaj Chaudhary Department of Neonatology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
  • Risha Devi Department of Neonatology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
  • Gugloth Krishna Charan Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
  • Zikra Syed Department of Transfusion Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
  • Daljit Kaur Department of Transfusion Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
  • Mayank Priyadarshi Department of Neonatology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20221076

Keywords:

Hemolytic disease of newborn, Neonatal hyperbilirubinemia, Rh incompatibility, Anti-C, Anti-E antibodies

Abstract

In settings with adequate coverage of anti-D immunoglobulin, minor blood group incompatibility has become an important cause of hemolytic disease of the newborn (HDN). We presented a series of cases of HDN of varying severities caused due to presence of anti-E and anti-C antibodies. Two neonates with anti-E antibodies developed jaundice requiring intensive phototherapy, while the course of the third neonate born to mother with Rh D isoimmunization was complicated by presence of anti-C antibodies, who needed double volume exchange transfusions for jaundice and packed red cell transfusions for anemia. Hearing screening and neurological examination at discharge were normal for all three neonates. These cases highlighted the need for appropriate testing for minor blood group incompatibility in unusual cases of HDN to initiate timely therapy and prevent neonatal morbidity and mortality.

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Author Biographies

Pankaj Chaudhary, Department of Neonatology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India

Academic (DM) Senior resident

Department of neonaology

AIIMS, Rishikesh

Uttarakhand, India

Risha Devi, Department of Neonatology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India

Academic (DM) Senior resident

Department of neonaology

AIIMS, Rishikesh

Uttarakhand, India

Gugloth Krishna Charan, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India

Junior resident

Department of pediatrics

AIIMS, Rishikesh

Uttarakhand, India

Zikra Syed, Department of Transfusion Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India

Junior resident

Department of transfusion medicine

AIIMS, Rishikesh

Uttarakhand, India

Daljit Kaur, Department of Transfusion Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India

Assisstant Professor

Department of transfusion medicine

AIIMS, Rishikesh

Uttarakhand, India

Mayank Priyadarshi, Department of Neonatology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India

Assisstant Professor

Department of neonaology

AIIMS, Rishikesh

Uttarakhand, India

References

Young Infants Clinical Signs Study Group. Clinical signs that predict severe illness in children under age 2 months: a multicentre study. Lancet Lond Engl. 2008;371(9607):135-42.

Westhoff CM. The Rh blood group system in review: A new face for the next decade. Transfusion (Paris). 2004;44(11):1663-73.

Moise KJ. Fetal anemia due to non-Rhesus-D red-cell alloimmunization. Semin Fetal Neonatal Med. 2008;13(4):207-14.

NICE guideline. Fact sheet: National institute of health and care excellence (2010) jaundice in newborn babies under 28 days. Available at: https://www.nice.org.uk/guidance/cg98. Accessed on 29 January 2022.

New HV, Berryman J, Bolton-Maggs PHB, Cantwell C, Chalmers EA, Davies T, et al. Guidelines on transfusion for fetuses, neonates and older children. Br J Haematol. 2016;175(5):784-828.

Avent ND, Reid ME. The Rh blood group system: a review. Blood. 2000;95(2):375-87.

Subramaniyan R. Phenotyping of clinically significant blood group antigens among the South Indian donor population. Hematol Transfus Cell Ther. 2021.

Setya D, Tiwari AK, Arora D, Mitra S, Mehta SP, Aggarwal G. The frequent and the unusual red cell phenotypes in Indian blood donors: A quest for rare donors. Transfus Apher Sci Off J World Apher Assoc Off J Eur Soc Haemapheresis. 2020;59(4):102765.

Thakral B, Saluja K, Sharma RR, Marwaha N. Phenotype frequencies of blood group systems (Rh, Kell, Kidd, Duffy, MNS, P, Lewis, and Lutheran) in north Indian blood donors. Transfus Apher Sci Off J World Apher Assoc Off J Eur Soc Haemapheresis. 2010;43(1):17-22.

Karagol BS, Zenciroglu A, Okumus N, Karadag N, Dursun A, Hakan N. Hemolytic disease of the newborn caused by irregular blood subgroup (Kell, C, c, E and e) incompatibilities: Report of 106 cases at a tertiary care centre. Am J Perinatol. 2012;29(6):449-54.

George AA, Simon CD. Anti-c (Little c) IgM: an uncommonly observed but expected phenomenon. Lab Med. 2014;45(4):142-5.

Huber AR, Leonard GT, Driggers RW, Learn SB, Gilstad CW. Case report: moderate hemolytic disease of the newborn due to anti-G. Immunohematology. 2006;22(4):166-70.

Bhutani VK, Zipursky A, Blencowe H, Khanna R, Sgro M, Ebbesen F, et al. Neonatal hyperbilirubinemia and Rhesus disease of the newborn: incidence and impairment estimates for 2010 at regional and global levels. Pediatr Res. 2013;74(1):86-100.

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Published

2022-04-25

How to Cite

Chaudhary, P., Devi, R., Charan, G. K., Syed, Z., Kaur, D., & Priyadarshi, M. (2022). Variable manifestations of minor blood group incompatibility. International Journal of Contemporary Pediatrics, 9(5), 480–482. https://doi.org/10.18203/2349-3291.ijcp20221076

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Case Series