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A case of anti‐Rd causing fetal anemia
Author(s) -
Rauch Stefan,
Ritgen Jochen,
Wißkirchen Matthias,
Bauerfeind Ursula,
Kohne Elisabeth,
Weinstock Christof
Publication year - 2017
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/trf.14078
Subject(s) - medicine , fetus , hemolytic disease of the newborn (abo) , anemia , pregnancy , antibody , titer , antigen , hemolytic anemia , fetal hemoglobin , immunology , obstetrics , hemoglobin , gastroenterology , biology , genetics
BACKGROUND Rd (SC4) is a low‐frequency antigen of the Scianna blood group system. Only very few reports on anti‐Rd in pregnancy exist. Mild to moderate hemolytic disease of the newborn caused by anti‐Rd has been reported. This report may add further information on the clinical significance of anti‐Rd for the fetus. CASE REPORT In a case of severe fetal anemia (hemoglobin concentration, 3.0 g/dL) repeated intrauterine transfusions were required. The strongly positive direct antiglobulin test (DAT) of the fetal red blood cells led to the diagnosis of hemolytic disease. The routine antibody screen was negative, extended testing revealed a maternal anti‐Rd with a titer of 256. Both the newborn and her father were confirmed to carry the SC*01.04 allele. CONCLUSION Anti‐Rd can cause fetal anemia. Low‐frequency antigens including Rd are normally not present on screening cells. Antibodies directed against low‐frequency antigens will usually not be detected by routine antibody screening in pregnancy. Thus, in cases of fetal anemia the DAT should always be included in the diagnostic workup.