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Case report

Hemolytic disease of the fetus and newborn owing to anti-U, successfully treated with repeated intrauterine transfusions

Hemolytic disease of the fetus and newborn (HDFN) owing to anti-U has rarely been reported. U is part of the MNS system. M and N glycoproteins are located on glycophorin A (GPA); S and s antigens are on glycophorin B (GPB). Individuals who lack GPB are S– and s– and also lack U. The U– phenotype occurs almost exclusively in the African population and has a very low frequency (0.25%). Anti-U is of immunoglobulin G class and can cause hemolytic transfusion reaction and HDFN. In

Johanna Strindberg, Joachim Lundahl, Gunilla Ajne

Immunohematology, Volume 29 , ISSUE 2, 51–54


Anti-Vel alloimmunization and severe hemolytic disease of the fetus and newborn

The Vel red blood cell (RBC) antigen was first described in 1952.1 The antigen is ubiquitous in the general population, with only 0.04 percent of Caucasian individuals failing to exhibit expression.2 Only rare cases of anti-Vel–associated mild-to-moderate hemolytic disease of the fetus and newborn (HDFN) have been previously reported.3–7 The neonatal manifestation of HDFN in these cases was limited to hyperbilirubinemia requiring only phototherapy. No case of fetal anemia requiring prenatal

K.J. Moise, Y. Morales, M.F. Bertholf, S.N. Rossmann, Y. Bai

Immunohematology, Volume 33 , ISSUE 4, 152–154


Severe hemolytic disease of the fetus and newborn due to anti-E and anti-Jka

Red blood cell (RBC) alloimmunization to antigens other than D, such as C, c, E, e, and antigens in the Kell, MNS, and Duffy blood group systems, has emerged as an important cause of hemolytic disease of the fetus and newborn (HDFN).1 Antibody screening for these antibodies is not routinely practiced for all antenatal patients in developing countries, mainly because of financial constraints. We report a case of HDFN in a female baby due to maternal alloimmunization against Rh and Kidd blood

S. Mandal, S. Malhotra, G. Negi, A. Tiwari, S. Mitra, S. Basu, P. Singh

Immunohematology, Volume 36 , ISSUE 2, 60–63


Campylobacter fetus is Internalized by Bovine Endometrial Epithelial Cells

Introduction Campylobacter fetus is a microaerophilic, Gram-negative bacterium that causes embryonic mortality, abnormal estrus cycles, reduced fertility and abortions in 5–10% of cases in cattle and sheep. C. fetus is divided into three subspecies: C. fetus subsp. fetus, C. fetus subsp. venerealis, and C. fetus subsp. testudinum. C. fetus subsp. venerealis is the etiologic agent of bovine genital campylobacteriosis, which causes infertility, abortions and embryonic death, and is mainly


Polish Journal of Microbiology, Volume 68 , ISSUE 2, 217–224


Campylobacter fetus Induced Proinflammatory Response in Bovine Endometrial Epithelial Cells

mechanisms have an important role in maintaining its integrity (Amjadi et al. 2014). The cells in mucosal epithelia recognize pathogens and stimulate the underlying immune cells like macrophages, inducing an inflammatory reaction via cytokines’ production, resulting in adaptive immunity activation. They also produce antimicrobial peptides that eliminate several bacterial and viral agents (Turner et al. 2014). Campylobacter fetus subsp. fetus is frequently isolated from the intestinal tract of


Polish Journal of Microbiology, Volume 70 , ISSUE 1, 99–106


Absence of hemolytic disease of fetus and newborn despite maternal high-titer IgG anti-Ku

Anti-Ku seen in K0 (Kell-null) individuals has previously been shown to cause severe hemolytic transfusion reactions. Maternal anti-Ku can cause none or moderate to severe hemolytic disease of the fetus and newborn (HDFN). In two of four previously described HDFN cases, intrauterine transfusions were required because of severe anemia. We report a case in which maternal anti-Ku did not cause HDFN. Standard serologic methods were used for RBC antibody screening and identification, adsorption and

Ram M. Kakaiya, Angelica Whaley, Christine Howard-Menk, Jigna Rami, Mona Papari, Sally Campbell-Lee, Zbigniew Malecki

Immunohematology, Volume 26 , ISSUE 3, 119–122

Case report

A twin pregnancy with a hydatidiform mole and a coexisting live fetus: prenatal diagnosis, treatment, and follow-up

Twin molar pregnancy with a hydatidiform mole and a coexisting live fetus is a rare form of gestational trophoblastic disease associated with an increased risk of obstetric complications and poor perinatal outcome. Prenatal diagnosis is essential for couple counseling and follow-up in Tertiary Reference Centers. Magnetic resonance imaging is important for the diagnostic differentiation of placental mesenchymal dysplasia and exclusion of myometrial invasion. Here we present a case of twin molar

Antonio Braga, Bruna Obeica, Heron Werner, Sue Yazaki Sun, Joffre Amim Júnior, Jorge Rezende Filho, Edward Araujo Júnior

Journal of Ultrasonography, Volume 17 , ISSUE 71, 299–305

Case report

Management of pregnancy sensitized with anti-Inb with monocyte monolayer assay and maternal blood donation

Maternal red blood cell (RBC) alloantibodies can cause hemolytic disease of the fetus and newborn (HDFN). Although much is described about common antibodies associated with HDFN, management of a pregnancy complicated by a maternal rare antibody presents several challenges related to assessment of fetal anemia risk, availability of blood for transfusion to the mother and/or the fetus or newborn if needed, and planning for delivery in the case of maternal hemorrhage. Here we report the laboratory

Raj Shree, Kimberly K. Ma, Lay See Er, Meghan Delaney

Immunohematology, Volume 34 , ISSUE 1, 7–10

Case report

Severe hemolytic disease of the fetus and newborn due to anti-C+G

Anti-G is commonly present with anti-D and/or anti-C and can confuse serological investigations. In general, anti-G is not considered a likely cause of severe hemolytic disease of the fetus and newborn (HDFN), but it is important to differentiate it from anti-D in women who should be administered anti-D immunoglobulin prophylaxis. We report one woman with three pregnancies severely affected by anti-C+G requiring intrauterine treatment and a review of the literature. In our case, the

Riina Jernman, Vedran Stefanovic, Anu Korhonen, Katri Haimila, Inna Sareneva, Kati Sulin, Malla Kuosmanen, Susanna Sainio

Immunohematology, Volume 31 , ISSUE 3, 123–127


Identifying obstetrics patients in whom RHD genotyping can be used to assess risk of D alloimmunization

directed at RBCs expressing the D antigen containing the missing epitope. Alloimmunization can occur via blood transfusion or pregnancy. The significance of D in pregnant women and in women of childbearing potential is well appreciated in the obstetrics community.4,5 Maternal alloanti-D can cause mild to severe hemolytic disease of the fetus and newborn (HDFN).6–8 Importantly, some partial D phenotypes may present with a serologic weak D phenotype, a fact that causes confusion based on the terminology

T.N. Horn, J. Keller, M.A. Keller, L. Klinger

Immunohematology, Volume 36 , ISSUE 4, 146–151

Case report

Fetal ultrasound: Early diagnosis and natural evolution of proximal femoral focal deficiency

Eugenio O. Gerscovich, Simran Sekhon, Thomas W. Loehfelm, Adam Greenspan

Journal of Ultrasonography, Volume 17 , ISSUE 71, 294–298


First example of an FY*01 allele associated with weakened expression of Fya on red blood cells

. Phenotypematched units were desired for a multi-transfused Vietnamese fetus with α-thalassemia. Genotyping of the fetus using a microarray assay that interrogates three SNPs (c.1-67, c.125, and c.265) in FY yielded indeterminate results for the predicted Duffy phenotype. Genomic sequencing of FY exon 2 showed that the fetal sample had one wild-type FY*01 allele and one new FY*01 allele with the c.265C>T SNP, which until recently had only been found on the FY*02 allele. Genotyping performed on samples

Patricia A. Arndt, Trina Horn, Jessica A Keller, Rochelle Young, Suzanne M. Heri, Margaret A. Keller

Immunohematology, Volume 31 , ISSUE 3, 103–107


Heat elution: a modification of the Landsteiner-Miller method

alloantibodies, due to drug-induced antibodies, or in the investigation of hemolytic disease of the fetus and newborn (HDFN).7 They may also be used in combination with in vitro adsorption studies to identify weakly expressed blood group antigens and for the identification of multiple alloantibodies. Indications for heat elution include: Investigation of ABO HDFN. Elution is rarely required, however, because the diagnosis is generally made from clinical findings consistent with HDFN in an ABO-incompatible

C. Dean-El, N. Quraishy

Immunohematology, Volume 35 , ISSUE 2, 45–47


Sulfhydryl treatment of serum or plasma for the reduction of IgM antibodies

Dithiothreitol (DTT) and 2-mercaptoethanol (2-ME) are sulfhydryl compounds that can be used to treat serum or plasma to denature IgM antibody reactivity. By using sulfhydryl agents, IgG and IgM antibodies can be separated, the relative amount of IgM and IgG antibodies can be determined, and the risk of hemolytic disease of the fetus and newborn can be assessed.

Lorraine N. Blagg

Immunohematology, Volume 34 , ISSUE 4, 135–139


Determining the significance of anti-K1 in hemolytic disease of the newborn (HDN)

and 17 were K:1,2; 21 were unavailable. Antibody titers were done on the mothers in the latter two groups. Women with titers < 32 were followed by titration studies; all delivered clinically unaffected infants, four of whom were K:1. Women with titers >32 had amniocentesis performed for optical density values (ΔOD450) or, after November 1987, were offered an alternative test, cordocentesis, to type the fetus and to do hemoglobins if the fetus was antigen-positive. Two women had

Patricia L. Strohm, Janice F. Blazina, Richard W. O'Shaughnessy, Melanie S. Kennedy, Jane M. Moore

Immunohematology, Volume 7 , ISSUE 2, 40–42

Case report

Possible suppression of fetal erythropoiesis by the Kell blood group antibody anti-Kpa

Antibodies to antigens in the Kell blood group system are usually immunoglobulin G, and, notoriously, anti-K, anti-k, and anti-Kpa can cause severe hemolytic transfusion reactions, as well as severe hemolytic disease of the fetus and newborn (HDFN). It has been shown that the titer of anti-K does not correlate with the severity of HDFN because, in addition to immune destruction of red blood cells (RBCs), anti-K causes suppression of erythropoiesis in the fetus, which can result in severe anemia

Michelle Tuson, Kim Hue-Roye, Karen Koval, Sherwin Imlay, Rajendra Desai, Gayatri Garg, Esam Kazem, Diane Stockman, Janis S. Hamilton, Marion E. Reid

Immunohematology, Volume 27 , ISSUE 2, 58–60


Prenatal diagnosis of congenitally corrected transposition of the great arteries

Nathalie Jeanne Bravo-Valenzuela, Alberto Borges Peixoto, Edward Araujo Júnior

Journal of Ultrasonography, Volume 19 , ISSUE 79, 314–317


Clinical significance of antibodies to antigens in the International Society of Blood Transfusion collections, 700 series of low-incidence antigens, and 901 series of high-incidence antigens

reaction (e.g., anti-AnWj, anti-Emm), or hemolytic disease of the fetus and newborn (e.g., anti-Kg, anti-HJK)—has been documented. Many other specificities have so far been benign (e.g., anti-Csa, anti-M1).

Christine Lomas-Francis

Immunohematology, Volume 34 , ISSUE 2, 39–45

Case report

Suspected acute hemolytic transfusion reaction mediated by anti-Dia

Anti-Dia can mediate hemolytic disease of the fetus and newborn, but it is unclear if it can cause hemolytic transfusion reactions (HTRs). To date, there has only been one report of a possible immediate HTR attributed to anti-Dia. Our case report details an immediate HTR due to anti-Dia in a patient with pre-existing liver failure. This reaction triggered multi-organ failure, and the patient subsequently died. This case also highlights the importance of considering HTRs even when routine

Ashwini Bennett, Ray K. Boyapati, Frank S. Hong

Immunohematology, Volume 31 , ISSUE 4, 163–165


A review of the JR blood group system

The JR blood group system (ISBT 032) consists of one antigen, Jra, which is of high prevalence in all populations. The rare Jr(a–) phenotype has been found mostly in Japanese and other Asian populations, but also in people of northern European ancestry, in Bedouin Arabs, and in one Mexican. Anti-Jra has caused transfusion reactions and is involved in hemolytic disease of the fetus and newborn. The Jra antigen is located on ABCG2 transporter, a multipass membrane glycoprotein (also known

Lilian Castilho, Marion E. Reid

Immunohematology, Volume 29 , ISSUE 2, 63–68

Case report

Blood group genotyping in a multitrauma patient: a case report

Currently DNA-based analysis of blood groups is mainly used to improve transfusion safety by reducing alloantibody formation in multiply transfused patients and by monitoring pregnancies at risk for hemolytic disease of the fetus and newborn. We present a case in which genotyping was performed after massive transfusion with unmatched group O, D– blood in a trauma setting. Our patient was genotyped as O1A1 and predicted to be D–, and we therefore transfused group A, D– red

Joyce Curvers, Volkher Scharnhorst, Masja de Haas, Loes Warnier-Wandel, Daan van de Kerkhof

Immunohematology, Volume 28 , ISSUE 3, 85–87


Autism spectrum disorder and mercury toxicity: use of genomic and epigenetic methods to solve the etiologic puzzle

, half of which is derived from maternal inheritance. Thus, the role of paternal genetics would be to increase or decrease vulnerability to mercury toxicity through impacting the fetal genome. Fetal and infant genetics determine the degree of toxicity derived from gestational and postpartum mercury exposure. The fetus or infant, therefore, is exposed to maternal genetic risks in two ways: 1)Maternally derived in utero mercury exposure related to maternal genetics and the mother’s exposure to mercury

Mark E. McCaulley

Acta Neurobiologiae Experimentalis, Volume 79 , ISSUE 2, 113–125


A fatal case of acute hemolytic transfusion reaction caused by anti-Wra: case report and review of the literature

Wra is the most common low-prevalence antigen (LPA) in the white population, and anti-Wra is the most common naturally occurring antibody.1 The first case of anti-Wra was described by Holman2 in 1953 in a child with severe hemolytic disease of the fetus and newborn (HDFN), requiring exchange transfusion. Anti-Wra is often identified when Wr(a+) red blood cells (RBCs) are available on the screening or identification panel RBCs, but the antibody is otherwise rarely involved in serious hemolytic

A. Espinosa, L.J. Garvik, N. Trung Nguyen, B. Jacobsen

Immunohematology, Volume 37 , ISSUE 1, 20–24

Case report

Body stalk anomaly: antenatal sonographic diagnosis of this rare entity with review of literature

phenomenon. Sonographic features of the fetus included a severe midline defect of the fetal abdominal wall with a large extra-abdominal mass containing bowel and liver inside. Body stalk anomaly is accepted as a fatal anomaly, so it is important to differentiate it from other anterior wall defects for evaluating the management options.

Amandeep Singh, Jasmeet Singh, Kamlesh Gupta

Journal of Ultrasonography, Volume 17 , ISSUE 69, 133–135



This paper proposed a system for detecting and approximating of a fetus in an ultrasound image. The fetal organs in the ultrasound image are detected using Multi Boundary Classifier based Adaboost.MH. The results of the fetal detection is then approximated Randomized Hough Transform and the whole showed a mean accuracy of 95.80%. The mean of the Hamming Error 0.019 and the Kappa coefficient value reaches 0.890.The proposed method has the best performancefor fetal organ detection. This is proven

M. Anwar Ma’sum, Wisnu Jatmiko, Budi Wiweko, Anom Bowolaksono

International Journal on Smart Sensing and Intelligent Systems, Volume 8 , ISSUE 1, 720–748


Clinical significance of antibodies to antigens in the Raph, John Milton Hagen, I, Globoside, Gill, Rh-associated glycoprotein, FORS, JR, LAN, Vel, CD59, and Augustine blood group systems

transfused antigenpositive red blood cells or a transfusion reaction (e.g., anti-P, anti-Jra, and anti-Lan), and/or hemolytic disease of the fetus and newborn (e.g., anti-RHAG4 and anti-Vel)—has been documented. For other antibodies, their prevalence is so rare that information on the clinical significance of their antibodies is not available (e.g., anti-FORS1).

Mostafa Moghaddam, Amir Ali Naghi

Immunohematology, Volume 34 , ISSUE 3, 85–90

Case report

Case report:moderate hemolytic disease of the newborn due to anti-G

Views expressed in this article are those of the author and do not reflect the official policy or position of the Department of the Navy, Department of Defense, or U.S.Government. The only previously published case of anti-G in a pregnant woman indicated that anti-G alone caused little, if any, fetal or neonatal hemolysis. This report describes an affected fetus with amnionitic fluid OD 450 absorbance values in the moderate zone of the Liley prediction graph who required prolonged phototherapy

Aaron R. Huber, George T. Leonard, Rita W. Driggers, Sakhone B. Learn, Colleen W. Gilstad

Immunohematology, Volume 22 , ISSUE 4, 166–170

Case report

Case report: IgG1 Rh antibodies causing moderate hemolytic disease of the newborn

A gravida 3, para 1, 32-year-old black female presented at 27 weeks gestation for routine prenatal serologic tests. She typed as group A, D positive, category DIII mosaic. IgG1 anti-D, -hrB, and -E were identified in her serum. Ultrasound revealed an apparently normal fetus with no evidence of hydrops or ascites. Amniocentesis, performed at 30, 33, and 35 weeks, showed some evidence of hemolysis that did not increase over time. At 36 weeks of gestation, she delivered a full-term infant who

C. Faye Kugele, Cindy K. Oliver, Maria A. Carney, Jayne Hollander

Immunohematology, Volume 10 , ISSUE 4, 124–126


A brief overview of clinical significance of blood group antibodies

can occur via exposure to foreign (donor) RBC antigens through previous transfusions, transplants, or exposure to fetal RBCs during or after pregnancy. However, not all blood group antibodies are clinically significant. Clinically significant blood group antibodies can cause adverse events after blood component transfusion or transplantation and/or can cause hemolytic disease of the fetus and newborn.

Manish J. Gandhi, D. Michael Strong, Barbee I. Whitaker, Evangelia Petrisli

Immunohematology, Volume 34 , ISSUE 1, 4–6


The Diego blood group system: a review

dioxide transport from tissues to lungs. It is also found in the kidney, where it is involved in acid secretion. Antibodies to Diego system antigens with the exception of anti-Dia, -Dib, -Wra, -ELO and -DISK do not seem to be of clinical significance for transfusion or of importance in hemolytic disease of the fetus and newborn.

Dolores Figueroa

Immunohematology, Volume 29 , ISSUE 2, 73–81


Clinical approach after identification of a rare anti-Ena in a prenatal sample

and Anstee4 showed that RBCs lacking GPA, the major sialoglycoprotein on the RBC surface, lack Ena. This deficiency reduces the overall zeta potential of an intact RBC resulting in RBCs with a higher propensity to agglutinate than RBCs expressing GPA.4 Antibodies against Ena have been associated with hemolytic transfusion reactions and hemolytic disease of the fetus and newborn (HDFN).5 We present a case of the rare Mk phenotype with allo-anti-Ena in a maternal prenatal sample. We discuss the

P.J. Howard, L. Guerra, D.K. Kuttner, M.R. George

Immunohematology, Volume 35 , ISSUE 4, 159–161


The Gerbich blood group system: a review

]). GPC and GPD interact with protein 4.1R, contributing stability to the RBC membrane. Reduced levels of GPC and GPD are associated with hereditary elliptocytosis, and Gerbich antigens act as receptors for the malarial parasite Plasmodium falciparum. Anti-Ge2 and anti-Ge3 have caused hemolytic transfusion reactions, and anti-Ge3 has produced hemolytic disease of the fetus and newborn (HDFN).

Phyllis S. Walker, Marion E. Reid

Immunohematology, Volume 26 , ISSUE 2, 60–65

Case report

An AQP1 allele associated with Co(a–b–) phenotype

deletion of a G at nucleotide 601 (nt601delG) that results in a frameshift and premature termination (Val201Stop). Available family members were tested for the allele. Although anti-Co3 has been associated with mild to severe hemolytic disease of the fetus and newborn, the antibody was not clinically significant as evidenced by a low titer and delivery of asymptomatic newborns with moderate to weakly positive direct antiglobulin tests for all four pregnancies.

Sunitha Vege, Sandra Nance, Donna Kavitsky, Xiaojin Li, Trina Horn, Geralyn Meny, Connie M. Westhoff

Immunohematology, Volume 29 , ISSUE 1, 1–4


MNS blood group system: a review

The MNS blood group system is second only to the Rh blood group system in its complexity. Many alloantibodies to antigens in the MNS system are not generally clinically significant although antibodies to low-prevalence and high-prevalence MNS antigens have caused hemolytic disease of the fetus and newborn. The MNS antigens are carried on glycophorin A (GPA), glycophorin B (GPB), or hybrids thereof, which arise from single-nucleotide substitution, unequal crossing over, or gene conversion

Marion E. Reid

Immunohematology, Volume 25 , ISSUE 3, 95–101


Kell and Kx blood group systems

, and alloantibodies to Kell antigens can cause transfusion reactions and hemolytic disease of the fetus and newborn. Kell alloantibodies in pregnancy are known to suppress erythropoiesis, which can result in serious disease despite low amniotic bilirubin levels and low antibody titers. Late-onset anemia with reticulocytopenia is thought to be attributable to the continual suppression of erythropoiesis from residual alloantibody in the infant. Alloimmunization to XK protein is rare, and expressed

Gregory A. Denomme

Immunohematology, Volume 31 , ISSUE 1, 14–19


The Duffy blood group system: a review

mutation upstream of the FY allele. This mutation prevents expression of Duffy glycoprotein on erythrocytes only, while permitting expression on nonerythroid cells. Other antigens include Fy3, Fy5, and Fy6. Antibodies to Duffy antigens are usually clinically signifi cant and have been reported to cause hemolytic disease of the fetus and newborn. This review provides a general overview of the Duffy blood group system, including the role of the Duffy glycoprotein as a chemokine receptor (Duffy antigen

Geralyn M. Meny

Immunohematology, Volume 26 , ISSUE 2, 51–56

Case report

Postpartum acute hemolytic transfusion reactions associated with anti-Lea in two pregnancies complicated by preeclampsia

, red blood cell units, compatible by electronic crossmatch, were issued and transfused. The subsequent transfusion reactions were characterized by acute intravascular hemolysis, evidenced by both clinical and laboratory criteria. These two cases demonstrate that, even when least anticipated, hemolytic transfusion reactions may occur. As expected, neither live-born neonate was affected by hemolytic disease of the fetus and newborn. Because both transfusion reactions occurred in non–group O

Marcia Marchese

Immunohematology, Volume 33 , ISSUE 3, 114–118


Clinical significance of antibodies to antigens in the Scianna, Dombrock, Colton, LandsteinerWeiner, Chido/Rodgers, H, Kx, Cromer, Gerbich, Knops, Indian, and Ok blood group systems

survival of transfused antigen-positive red blood cells or a transfusion reaction (e.g., anti-Ge2, anti-H) and/or hemolytic disease of the fetus and newborn (e.g., anti-Coa , anti-Ge3)— has been documented. Some of these antibodies are not always clinically significant, and because of the high prevalence of the antigen, antigen-negative blood may be extremely difficult to find (e.g., anti-LW, anti-Inb). The use of a monocyte monolayer assay may be helpful when making transfusion decisions for

Sofia Lejon Crottet

Immunohematology, Volume 34 , ISSUE 3, 103–108

Case report

Blocked D phenomenon and relevance of maternal  serologic testing

a case of hemolytic disease of fetus and newborn with a positive DAT.

Ashish Jain, Vijay Kumawat, Neelam Marwaha

Immunohematology, Volume 31 , ISSUE 3, 116–118


The Augustine blood group system, 48 years in the making

phenotype, has only been found in individuals of African origin. Anti-Ata has been implicated in immediate and delayed hemolytic transfusion reactions, but not in severe hemolytic disease of the fetus and newborn. The Augustine gene is SLC29A1, which encodes the equilibrative nucleoside transporter ENT1. At(a–) (AUG:–1,2) results from homozygosity for c.1171G>A, encoding Glu391Lys, whereas the AUGnull (AUG:–1,–2) phenotype results from homozygosity for a splice site mutation

Geoffrey Daniels

Immunohematology, Volume 32 , ISSUE 3, 100–103


The LAN blood group system: a review

described as having   variable clinical significance, either for hemolytic transfusion reactions (none to severe) or hemolytic disease of the fetus and newborn (none to mild). Despite challenging conditions caused by the scarcity of Lan– donors worldwide, Lan– blood should ideally be given to patients with anti-Lan, especially those with a high-titer antibody.

Thierry Peyrard

Immunohematology, Volume 29 , ISSUE 4, 131–135


P1PK: The blood group system that changed its name and expanded

is generally a weak and cold-reactive antibody not implicated in hemolytic transfusion reaction (HTR) or hemolytic disease of the fetus and newborn while Pk antibodies can cause HTR, and anti-NOR is regarded as a polyagglutinin. A higher frequency of miscarriage is seen in women with the rare phenotypes p, P1k, and P2k. Furthermore, the Pk and P1 antigens have wide tissue distributions and can act as host receptors for various pathogens and toxins. Why p individuals lack not only Pk and P

Åsa Hellberg, Julia S. Westman, Britt Thuresson, Martin L. Olsson

Immunohematology, Volume 29 , ISSUE 1, 25–33


The Vel blood group system: a review

. Clinically, anti-Vel is important and has caused severe transfusion reactions, although hemolytic disease of the fetus and newborn caused by anti-Vel is uncommon. However, while screening for Vel– blood donors has become easier, the function of SMIM1 is still unknown, and despite its well-conserved sequence across the animal kingdom, the enigma continues.

Jill R. Storry, Thierry Peyrard

Immunohematology, Volume 33 , ISSUE 2, 56–59

Case report

A LU:−16 individual with antibodies

>T (LU:–16), and a silent polymorphism c.1227G>T. Anti-Lu16 was highly suspected. This would be the fifth case of LU:–16 with antibodies reported, all within women of African heritage with the Lu(a+b−) phenotype. Hemolytic disease of the fetus and newborn was not noted in these cases.

Carole Éthier, Cynthia Parent, Anne-Sophie Lemay, Nadia Baillargeon, Geneviève Laflamme, Josée Lavoie, Josée Perreault, Maryse St-Louis

Immunohematology, Volume 33 , ISSUE 3, 110–113



phenotype arises from homozygosity for inactivating mutations in the LU gene. The dominantly inherited Lumod phenotype, In(Lu), results from heterozygosity for inactivating mutations in KLF1, the gene for the erythroid transcription binding factor EKLF. Clinically, antibodies of the Lutheran system are relatively benign. When hemolytic, they generally cause only mild, delayed hemolytic transfusion reactions or hemolytic disease of the fetus and newborn that can be treated by phototherapy. The Lutheran

Geoff Daniels

Immunohematology, Volume 25 , ISSUE 4, 152–159


Update on HDFN: new information on long-standing controversies

Hemolytic disease of the fetus and newborn (HDFN) results from maternal IgG antibodies that cross the placenta to the fetal circulation during gestation and cause RBC destruction and complications before birth (HDF), or anemia and hyperbilirubinemia after birth (HDN), or both. In its most severe form,HDF produces hydrops fetalis,which is characterized by total body edema,hepatosplenomegaly,and heart failure and can lead to intrauterine death. Before discovery of Rh immunoglobulin (RhIG), HDFN

Anne F. Eder

Immunohematology, Volume 22 , ISSUE 4, 188–195

Review Article

Current knowledge on the use of ultrasound measurements of fetal soft tissues for the assessment of pregnancy development

Ultrasonography, with its detailed imaging of the fetus, is very widely used in obstetrics. The primary aim of ultrasound scanning in pregnancy is to limit the risk of obstetric complications by early detection of abnormalities, such as intrauterine growth restriction and macrosomia. Currently, morphometric formulae are used for estimating fetal weight. They utilize basic biometric parameters. However, Hadlock formula, used for fetal weight estimation, has an error rate of 20%. For this reason

Aleksandra Warska, Anna Maliszewska, Anna Wnuk, Beata Szyszka, Włodzimierz Sawicki, Krzysztof Cendrowski

Journal of Ultrasonography, Volume 18 , ISSUE 72, 50–55


The potential of blood group genotyping for transfusion medicine practice

atypical antibodies carries a risk for hemolytic disease of the fetus and newborn, or at the very least, monitoring for an atrisk pregnancy.

Connie M. Westhoff

Immunohematology, Volume 24 , ISSUE 4, 190–195


Two Thai Burmese descendants with A4GALT*01N.21, p phenotype, and anti-PP1Pk

RBC or pregnancy sensitization. The absence of all three antigens leads to the rare p phenotype and the production of the mixture component antibody, anti-PP1Pk.2,3 This antibody is often associated with hemolytic transfusion reaction (HTR), hemolytic disease of the fetus and newborn (HDFN), and spontaneous abortion in early pregnancy.4 Anti-PP1Pk has been found to be a mixture of IgM and IgG isotypes and able to react over a wide range of temperatures and potentially bind and activate complement

K. Intharanut, W. Sasikarn, W. Chusri, O. Nathalang

Immunohematology, Volume 36 , ISSUE 2, 64–68

Case report

Two cases of the variant RHD*DAU5 allele associated with maternal alloanti-D  

Rh is a complex blood group system with diverse genotypes that may encode weak and partial D variants. Standard serologic analysis may identify clinically significant D variants as D+; nevertheless, individuals with these D variants should be managed as D– patients to prevent antibody formation to absent D epitopes. Variant identification is necessary during pregnancy to allow for timely and appropriate Rh immune globulin (RhIG) prophylaxis for hemolytic disease of the fetus and newborn

Jennifer A. Duncan, Susan Nahirniak, Rodrigo Onell, Gwen Clarke

Immunohematology, Volume 33 , ISSUE 2, 60–63


Laboratory methods for Rh immunoprophylaxis: a review

for detecting a fetomaternal hemorrhage in D+ mothers or when the D type of the fetus or newborn is D– or unknown. The acid-elution (Kleihauer- Betke) assay is a sensitive laboratory method for quantifying a fetomaternal hemorrhage, but it is tedious, often inaccurate, and difficult to reproduce. Flow cytometry, using anti-D or anti- hemoglobin F reagents, offers a more precise quantification of fetal RBCs in maternal blood. However, flow cytometry services for this function are available in

S. Gerald Sandler, Srividya Sathiyamoorthy

Immunohematology, Volume 26 , ISSUE 3, 92–103

Case report

Anti-Kpa–induced severe delayed hemolytic transfusion reaction

Kpa is a low-frequency antigen occurring in less than 2 percent of the Caucasian population. Mild to moderate delayed hemolytic transfusion reactions (DHTR) and hemolytic disease of the fetus and newborn attributable to anti-Kpa have been reported. Severe overt DHTR has not been reported with anti-Kpa. A case of a severe DHTR attributed to anti-Kpa after multiple RBC transfusions is being reported. A 52-year-old Caucasian woman received multiple units of RBCs for a lower gastrointestinal bleed

Ranie Koshy, Bhishma Patel, Jonathan S. Harrison

Immunohematology, Volume 25 , ISSUE 2, 44–47


Neonatal alloimmune thrombocytopenia due to anti-HPA-2b (anti-Koa)

Most severe cases of neonatal alloimmune thrombocytopenia (NAIT) are due to anti-HPA-1a (anti-PlA1) antibodies. We report a case of NAIT due to anti-HPA-2b that resulted in in utero intracranial hemorrhage.A 33-year-old G2P1A0 Caucasian woman had a routine ultrasound at 34 weeks. The fetus appeared to have a left hemispheric hematoma. IVIG, 1g/kg, was started immediately and administered weekly until delivery. One day after receiving the first dose of IVIG, fetal platelet count was 18 ×

Mindy Goldman, Élise Trudel, Samir Khalife, Gwendoline M. Spurll

Immunohematology, Volume 19 , ISSUE 2, 43–46


Prevalence of clinically significant red blood cell alloantibodies in pregnant women at a large tertiary-care facility

More than 50 red blood cell (RBC) alloantibodies are known to cause hemolytic disease of the fetus and newborn (HDFN). Although Rh immune globulin (RhIG) prophylaxis has significantly reduced the incidence of pregnancies complicated by anti-D, the need to detect and monitor maternal alloantibodies capable of causing HDFN is still a concern. The prevalence and specificity of these alloantibodies were determined. In this retrospective study, the prevalence and specificities of unexpected RBC

Heather M. Smith, Rosetta S. Shirey, Sandra K. Thoman, Jay B. Jackson

Immunohematology, Volume 29 , ISSUE 4, 127–130

Case report

Serologic and molecular characterization of D variants in Brazilians: impact for typing and transfusion strategy

;related hemolytic disease of the fetus and newborn.

Débora Castilho Credidio, Jordão Pellegrino Jr., Lilian Castilho

Immunohematology, Volume 27 , ISSUE 1, 6–11

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