Neonatal hemolytic disease due to anti-A1 accompany fetomaternal transfusion: A case report

Abstract

Abstract Background: A neonatal with severe anemia（HB:48g/L）was detected before blood transfusion. A major crossmatch-incompatible result was found with a AB donor and the further some of random 8 donors. To diagnosis the reason of anemia and the mismatched, a series serological tests were detected. Case presentation: The AB positive neonatal was born by B positive mother and AB dad. The neonatal DAT was negative, but the elution was positive with A1 cell and negative with A2 cell. In his mother serum, titer 1024 anti-A were checked out in saline tube, after treated by DTT, titer 64 anti-A1 and 2 anti-A were checked out. The neonatal was diagnosis with Hemolytic disease of the newborn (HDFN). His mother red cell showed a weak agglutinated with anti-A under microscopy. Then was diagnosis as fetomaternal hemorrhage (FMH) through the Kleihauer-Betke test and flow cytometry. A2B red blood were given combine with phototherapy, the neonatal HB was 108g/L on the day 11 before discharged. Conclusions: This is a rare case concurrent FMH and HDFN. The massive red cell of fetus entried maternal blood because of FMH, and then AB fetus red blood tiggered the high titer anti-A1 IgG and caused HDFN.