ABO Blood-Group System ; Erythroblastosis, Fetal ; epidemiology ; Humans ; Infant, Newborn

The Rh blood group system is one of the most complex and important systems known in humans. It has two homologous structure genes in tandem on 1p34.3-36.1 that encode Rh protein. The Rh protein is a membrane in red blood cell that has 12 transmembrane spans. Rh antigens have many variants; there are three genetic polymorphisms in the RhD-negative individual. The Rh blood group system is of great significance in clinical transfusion and hemolytic disease of the newborn (HDN). Rh PCR genotyping is used for prenatal diagnosis in fetus, but still it has some defects, and in this connection further knowledge about Rh system will be necessary to solve the problem.
Erythroblastosis, Fetal ; blood ; Humans ; Infant, Newborn ; Rh-Hr Blood-Group System ; blood ; genetics

Fetal erythroblastosis caused by maternal Rhesus alloimmunization brings a significant clinical problem, eventually leading to fetal hydrops and intrauterine fetal death. Repeated blood transfusions into the umbilical vein are the treatment of choice for fetal erythroblastosis with severe hydrops. The purpose of this report is to introduce our experience with a case of fetal erythroblastosis, recovered after intraumbilical venous transfusions. The fetus has been received the intraumbilical venous transfusions for four times from 29 weeks of gestation. Fetal hydrops and cardiomegaly, as well as polyhydramnios were improved markedly after transfusions. A healthy baby was delivered at 34 weeks of gestation. Intraumbilical venous transfusion may be a safe and effective treatment on the case with severe aggressive anemic and hydropic isoimmune fetus.
Blood Transfusion ; Cardiomegaly ; Edema ; Erythroblastosis, Fetal* ; Fetal Death ; Fetal Therapies ; Fetus ; Hydrops Fetalis ; Infant, Newborn ; Polyhydramnios ; Pregnancy ; Umbilical Veins

Erythroblastosis, Fetal ; blood ; diagnosis ; Female ; Humans ; Infant, Newborn ; MNSs Blood-Group System

Blood Group Incompatibility ; complications ; Erythroblastosis, Fetal ; etiology ; Humans ; Infant, Newborn ; MNSs Blood-Group System ; immunology ; Male

OBJECTIVE: To analyze the causes of positive irregular antibody screening test and incompatibility of cross matching in one patient with autoimmune hemolytic anemia complicated with neonatal hemolytic disease, and to accurately identify the type of antibodies in patients, and to select a reasonable strategy for blood transfusion. METHODS: One children was enrolled, blood group positive and reverse typing, Rh typing, direct anti-human globulin test, free test, dispersal test and cross matching test were carried out by test tube method and microcolumn gel card; irregular antibodies were identified by the reaction of DTT treatment and untreated panel cells with patients' plasma. RESULTS: The blood group of the patient was RhD positive B and irregular antibody screening positive, while the blood group of the mother was RhD positive O and irregular anti-screening negative, the result showed that the anti-LW detected in the plasma of the patient was autoantibody and ABO neonatal hemolytic disease (ABO-HDN) was present. Both O type RhD positive washing RBCs and B type RhD negative RBCs were transfused effectively. CONCLUSION Irregular antibodies in patients are anti-LW antibodies, and transfusion of homotype RhD negative suspended erythrocytes after the exclusion of ABO-HDN shows a better effect.
Anemia, Hemolytic, Autoimmune ; Autoantibodies ; Blood Group Incompatibility ; Blood Transfusion ; Erythroblastosis, Fetal ; Humans

Erythroblastosis, Fetal ; etiology ; Female ; Humans ; Infant, Newborn ; Rh-Hr Blood-Group System ; immunology

Diseases in Twins ; Erythroblastosis, Fetal ; genetics ; Female ; Humans ; Infant, Newborn ; MNSs Blood-Group System ; immunology

The Kidd blood group is clinically significant since the Jk antibodies can cause acute and delayed transfusion reactions as well as hemolytic disease of newborn (HDN). In general, HDN due to anti-Jk(b) incompatibility is rare and it usually displays mild clinical symptoms with a favorable prognosis. Yet, we apparently experienced the second case of HDN due to anti-Jk(b) with severe clinical symptoms and a fatal outcome. A female patient having the AB, Rh(D)-positive boodtype was admitted for jaundice on the fourth day after birth. At the time of admission, the patient was lethargic and exhibited high pitched crying. The laboratory data indicated a hemoglobin value of 11.4 mg/dL, a reticulocyte count of 14.9% and a total bilirubin of 46.1 mg/dL, a direct bilirubin of 1.1 mg/dL and a strong positive result (+++) on the direct Coomb's test. As a result of the identification of irregular antibody from the maternal serum, anti-Jk(b) was detected, which was also found in the eluate made from infant's blood. Despite the aggressive treatment with exchange transfusion and intensive phototherapy, the patient died of intractable seizure and acute renal failure on the fourth day of admission. Therefore, pediatricians should be aware of the clinical courses of hemolytic jaundice due to anti-Jk(b), and they should be ready to treat this disease with active therapeutic interventions.
Bilirubin/blood ; Erythroblastosis, Fetal/*blood ; Fatal Outcome ; Female ; Humans ; Infant, Newborn ; Isoantibodies/blood ; Kidd Blood-Group System/*immunology

OBJECTIVETo analyze the data about red blood cell alloantibodies in patients from mainland China and to provide evidence for formulating a management guideline.

METHODSThe Chinese and English literatures about Chinese patients in mainland China published in periodicals were retrieved by CHKD, CNKI, CMJD and PubMed using the key words as unexpected antibody, irregular antibody, blood group antibody, hemolytic transfusion reaction (HTR), hemolytic disease of the newborn (HDN), hemolytic disease of the fetus and newborn (HDFN).

RESULTSA total of 5582 red blood cell alloantibodies were retrieved from 4800 patients. The average prevalence of alloantibody in 89 retrospective analysis reports was 0.34 %. Among all study patients, the 10 most common antibodies were anti-E (33.9%), anti-D (18.3%), anti-c (10.9%), anti-M (9.9%), anti-C (8.1%), anti-e (4.8%), anti-Le(a) (3.4%), anti-P1 (2.0%), anti-Mur (1.6%), and anti-Jk(a) (1.2%). Out of all 136 patients with HTR, the most frequentl alloantibodies were Rhesus antibodies (71.7%), and other antibodies included anti-Jk(b) (5.9%), anti-Le(a) (5.1%), anti-Jk(a) (3.7%), anti-M (1.5%), and anti-Mur (1.5%). A total of 644 alloantibodies contributing to HDFN come primarily from the Rhesus (93.1%) and MNS (6.0%) blood group systems.

CONCLUSIONThe postnatal Rh prophylaxis should become a routine procedure in mainland China. The use of blood matched for C, E, c, e, Jk(a) and Jk(b) should be recommended for Chinese patients with a history of multiple transfusions. Patients with MNS alloantibodies should be given sufficient attention, and Mur+ red blood cells should be included in antibody screening panels.

Asian Continental Ancestry Group ; Blood Group Antigens ; Blood Transfusion ; China ; Erythroblastosis, Fetal ; Erythrocytes ; Humans ; Infant, Newborn ; Isoantibodies ; Prevalence ; Retrospective Studies