Abstract
Maternal antibody-mediated fetal red blood cell destruction secondary to non-D Rhesus (Rh) antibodies is a significant cause of hemolytic disease of the newborn (HDN). Here, we report a rare case of severe HDN associated with maternal antibody to Rh e. In addition to severe anemia, the infant developed thrombocytopenia, conjugated hyperbilirubinemia and cholelithiasis. Resolution of the infant's cholelithiasis occurred following treatment with ursodeoxycholic acid.
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De Alarcón PA, Werner EJ . Neonatal Hematology. Cambridge University Press: New York, 2005, pp 116–117.
Schonewille H, van de Watering LM, Loomans DS, Brand A . Red blood cell alloantibodies after transfusion: factors influencing incidence and specificity. Transfusion 2006; 46: 250–256.
Faas BH, Simsek S, Bleeker PM, Overbeeke MA, Cuijpers HT, von dem Borne AE et al. Rh E/e genotyping by allele-specific primer amplification. Blood 1995; 85: 829–832.
Westhoff CM . The Rh blood group system in review: a new face for the next decade. Transfusion 2004; 44: 1663–1673.
Chapman J, Waters AH . Haemolytic disease of the newborn due to Rhesus anti-e antibody. Vox Sang 1981; 41: 45–47.
Moncharmont P, Juron-Dupraz F, Rigal D, Vignal M, Meyer F . Haemolytic disease of two newborns in a Rhesus anti-e alloimmunized woman. Review of literature. Haematologia 1990; 23: 97–100.
Hanzlick RL, Senhauser DA . Subclinical hemolytic disease of the newborn due to anti-e. Am J Clin Pathol 1979; 72: 76–79.
Eder AF . Update on HDFN: new information on long-standing controversies. Immunohematology 2006; 22: 188–195.
Allgood C, Bolisetty S . Severe conjugated hyperbilirubinaemia and neonatal haemolysis. Int J Clin Pract 2006; 60: 1513–1514.
Maisels MJ . The clinical approach to the jaundiced newborn. In: Maisels MJ, Watchko JF (eds). Monographs in Clinical Pediatrics: Neonatal Jaundice, vol. 11 Harwood Academic Publishers: Amsterdam, 2000, pp 162–163.
American Academy of Pediatrics, Subcommittee on Hyperbilirubinemia. Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics 2004; 114: 297–316.
Jacir NN, Anderson KD, Eichelberger M, Guzzetta PC . Cholelithiasis in infancy: resolution of gallstones in three of four infants. J Pediatr Surg 1986; 21: 567–569.
Chen CY, Tsao PN, Chen HL, Chou HC, Hsieh WS, Chang MH . Ursodeoxycholic acid (UDCA) therapy in very-low-birth-weight infants with parenteral nutrition associated cholestasis. J Pediatr 2004; 145: 317–321.
Alcock GS, Liley H . Immunoglobulin infusion for isoimmune haemolytic jaundice in neonates. Cochrane Database Syst Rev 2002; (3): CD003313.
Gottstein R, Cooke RW . Systematic review of intravenous immunoglobulin in haemolytic disease of the newborn. Arch Dis Child Fetal Neonatal Ed 2003; 88: F6–F10.
Anderson D, Ali K, Blanchette V, Brouwers M, Couban S, Radmoor P et al. Guidelines on the use of intravenous immune globulin for hematologic conditions. Transfus Med Rev 2007; 21: S9–S56.
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The opinions expressed in this paper are solely those of the authors and do not represent the views of the United States Air Force, the United States Navy, the Department of Defense or the United States Government.
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McAdams, R., Dotzler, S., Winter, L. et al. Severe hemolytic disease of the newborn from anti-e. J Perinatol 28, 230–232 (2008). https://doi.org/10.1038/sj.jp.7211897
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DOI: https://doi.org/10.1038/sj.jp.7211897
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