Severe Fetal Hemolysis and Cholestasis Due to High-Titer Maternal IgG Anti-A Antibodies

Author:

Zonneveld Rens1,van der Meer-Kapelle Laura1,Sylva Marc2,Brand Anneke3,Zijlstra Marianne4,Schonewille Henk5

Affiliation:

1. Department of Pediatrics and

2. Department of Pediatrics, Sophia Children’s Hospital, Erasmus Medical Center, Rotterdam, Netherlands;

3. Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden University, Leiden, Netherlands;

4. Clinical Laboratory, Reinier de Graaf Gasthuis, Delft, Netherlands;

5. Department of Experimental Immunohematology, Sanquin, Amsterdam, Netherlands

Abstract

ABO blood group incompatibility between mother and fetus can lead to hemolytic disease of the fetus and newborn (HDFN). We present the first case of severe O/A HDFN associated with extremely high-titer (1:32 000) immunoglobulin G anti-A antibodies in a Cameroon mother. Cord blood analysis revealed severe fetal hemolytic anemia and conjugated hyperbilirubinemia. After exclusion of an underlying disease and other risk factors, cholestasis resolved after treatment with ursodeoxycholic acid, a red blood cell transfusion, and intravenous immunoglobulins. This case is presented to create awareness for a more severe course of ABO HDFN in nonwhite and non-European mother-child pairs.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology and Child Health

Reference42 articles.

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